Online Registration | Vision Dance Center

2024-2025
VDC Student Registration

First name

Last name

Date of Birth

Parent/Guardian Name (if under 18)

Secondary Email

Phone

Alternate Phone

Street Address

City

State

ZIP

WAIVER/RELEASE OF LIABILITY

The practice of dance involves the risk of physical injury (with bruises being the most likely injury and broken bones or other more serious physical injuries also being possible.) Understanding this I declare:

That I am willing to accept responsibility for such an eventuality, and;
That I have adequate medical insurance for such an eventuality, and;
That I will not hold any club, member, instructor, or the owners or operators of any facility in which I might practice liable for any injury that I might sustain while practicing dance in or outside of the studio.

Further, I understand the physical demand of this activity and the practice required for its development and mastery. As a consideration for my own safety and enjoyment, as well as that of other students, I commit to dedicate necessary practice of the instructions and techniques given to me in class.

Your Signature

PHOTO RELEASE

I hereby grant permission to Vision Dance Center to use photographs and/or video of me taken at Vision Dance Center's studios and/or its events, workshops, performances, or other VDC hosted functions in publications, news releases, online, and in other communications related to the mission of Vision Dance Center.

Your Signature

Name/Loction (if applicable)

Would you like to set up automatic payments so you never miss a payment and avoid late fees?

Yes

* The form may take a few seconds to submit. If the "Register" button goes grey, but you are not redirected to a confirmation page after a minute, please email info@visiondancecenter.org to confirm we have received your registration.

2024-2025 VDC Student Registration

2024-2025
VDC Student Registration