Session Registration FormadminJanuary 7, 2021July 22, 2022 Please enable JavaScript in your browser to complete this form. Use this form for short session classes. Student InformationStudent Name *FirstLastBirthdate *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Age *Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodePrimary Parent/Guardian Name: *Contact Phone # *Email Address *EmailConfirm EmailSecondary Parent/Guardian Name:Past Experience Please list any past experience. Dance InformationSelect your interest in the following dance styles below. (Check all that apply) Please refer to schedule for days/times. Classes Requested *Parent & Tot SessionPre DanceBalletPointeJazzAcroLyrical/ContempHip HopTapCardio & ConditioningStretch & Ballet TechJumps & TurnsRequested Class/Day/Time: (Please refer to schedule and list alternate options if available) *Registration Policies and Agreements:A non-refundable registration fee of $15 is required before registration is processed. Photo Release *I have read the following and agreeI do hereby give TK Danceworx, its assigns, licensees, and legal representatives the irrevocable right to use my picture, portrait, or photograph in all forms and media and in all manners, including composite, for advertising, for publication, for websites and or any other lawful purposes, and I waive any right to inspect or approve the finished product, including written copy, which may be created in connection therewith. This can be changed later by submitting a signed letter to Tina Kyle. Waiver and Release *I have read the following and agreeI agree that if my dependent or I (heretofore known as “we”) engage in any physical exercise, class, or activity, or facility on the premises or any venue where we participate as representatives of TK Danceworx Inc., we do so at our own risk. I agree that we are voluntarily participating in activities and use of said facilities, premises (including the parking lot) and designated TK Danceworx Inc. venues. We assume all risk of injury, illness, damage, or loss to us or our property that might result, including, without limitation, any loss or theft of any personal property. I agree that this consent and assumption of risk statement covers each and every event or activity sponsored by TK Danceworx Inc.. I agree to release and discharge you (and your affiliates, employees, agents, representatives, successors, and assigns) from any and all claims or cause of action (known or unknown) arising out of your negligence. I acknowledge that I have carefully read this Waiver and Release and fully understand that it is a release of liability. I am waiving any right that I may have to bring legal action to assert a claim against you for your negligence. Covid-19 *I have read the following and agreeTK Danceworx has taken a number of steps in order to ensure the safety of students, staff and the greater community. You can view the operating procedures here www.tkdanceworx.com/covid-policies/. In the event of another lock-down mandating by the Federal or Provincial government, no refunds will be given, and the studio will move to back to a online class curriculum. I realize that participation in dance classes and activities could result in some possible personal injury. Despite precautions being taken by the studio, accidents and injuries may occur. By signing this release form, I/we (the dancer and parent/guardian) assume all risks related to any and all virtual classes with the TK Danceworx Inc. I agree to release from responsibility TK Danceworx Inc. including all teachers, dancers, staff members, and facilities (where applicable) used by both entities from any cause of action, claims, or demands now and in the future. I will not hold TK Danceworx Inc. liable for any personal injury including but not limited to scrapes, bruises, cuts, sprains, fractures, broken bones, concussions, death or any personal property damage/loss, which may occur before, during or after virtual classes. Submit