Woodbridge Academy of Dance

ENROLLMENT FORM 2018

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Student Name:

DOB:

Address:

E-mail address: *

Primary Contact Name:

Telephone:

Secondary Contact Name:

Telephone:

I hereby consent to the participation of said minor above in WAD/WDC activities. Photos/Videos of minor may be used in marketing and social medias.

I hold WAD/WDC and its employees or contractors harmless for any cost, claim, injury, damage, or liability incurred at the facility or event venue.

In the event of injury or illness, I authorize the staff to administer first id and if necessary, request emergency medical services.

I understand a copy of the "Release and Waiver of Liabiltiy and Indemnity Agreement" is available to me upon my request.

List the classes interested in: *

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For Class Placement & Rates
Email us at:
Office@WoodbridgeAcademy.Dance

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