Autumn Hill - L'dance Classes and Parties

Full Name of Parent/Guardian:

Parent/ Guardian Email:

Phone Number:

Full Name of Child:

First

Last

Grade and Class of Child:

Birthdate of child:

Age Group:

Special Needs & or Allergies:

Date(s) of enrolment:

Payment Agreement:

I hereby agree to submit payment to L'Dance by either Credit card or E-transfer to [email protected] within the next 24 hours in order to secure my enrolment. Failure to do so will result in the deletion or invalidation of this registration. Please ensure to use the password 'dance22' and include your email address in the notes section.

I agree to allow any photographs taken in connection with L’Dance activities to be used for the promotional and advertising purpose of L’Dance.

Liability Waiver and Consent:

I acknowledge that participation in all activities, exercises, and dances carries inherent risks, and is done so at the participant's own risk. I am aware of the potential for personal injury and agree to release and indemnify L’Dance, including its principals, instructors, employees, and students, from any liability, damages, expenses, or losses resulting from any accident or injury, whether known or unknown, to the child or others during their participation in the program. I understand that all payments are non-refundable, and agree to abide by the rules and regulations stated above by checking the box provided.

Stripe Credit Card

Autumn Hill Registration