Woodbridge Academy of Dance

Fall/Winter session 2020

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Student Name: *

DOB: *

Address: *

E-mail address: *

Primary Contact Name: *

Cell Number: *

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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, illness, damage, or liability incurred at the facility or event venue.

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

I have read and consent to the COVID-19 Guidelines.

(New Students) List the classes interested in:

(New Students) List any experience:

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I wish to participate on-line until otherwise noted. *

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

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