San Diego Danceworks Registration

Student Information:

Students Name:
Birthdate:
Address
City
State	Zip Code
Age:	Grade:
Email:
Contact Phone#:
Person Responsible for Payment (if different from above):
Name:
Email:
Work Number:
Cell Number:
Address:
City:
State	Zip Code:
Emergency Contact:
Name:
Relationship:
Home Number:
Work Number:
Cell Number:
How did you hear about San Diego Danceworks?
Waiver of Injury: I, the undersigned, do hereby assume full responsibility for any and all damages, injuries or losses that I may sustain or incur, if any, while participating in activities at San Diego Danceworks. I hereby waive all claims against the owners, operators, instructors or other student of San Diego Danceworks for any claim for injuries that I may sustain. I agree to adhere to all tuition and studio policies of San Diego Danceworks as outlined. If under 18, this release and consent is to be signed by the parent or guardian. By selecting this button, this is a digital signature/confirmation of Waiver.

Paper Registration Form