Parent's Name *

Parent's Name

First Name

Last Name

Email Address *

Childs Name *

Childs Name

First Name

Last Name

D.O.B *

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

Phone

(###)

###

####

Tell us more! *

Please tell us more about your child. Are they shy? Have Has your child danced before? Do they have any friends in our school?

How did you hear about us? *

Date you'd like to take your first class? *

Date you'd like to take your first class?

YYYY

Release *

I understand the inherent nature of dance activities to include movement and equipment that create risk and the possibility of accidental physical injury. I release Etoile Arts, Inc, D.B.A Dance with Miss Alice and all staff harmless of all liability, and hereby acknowledge that I knowingly and voluntarily assume full responsibility for all risks of physical injury, illness or damages arising out of active participation in dance, yoga and movement on behalf of the participant in activities by Etoile Arts, Inc, Dance with Miss Alice. I understand that it is my responsibility to carry medical and accidental injury insurance covering the enrolled participant and I confirm that the enrolled participant is in good health. I understand that Etoile Arts, Inc, Dance with Miss Alice is not responsible for lost or stolen valuables. I understand that Etoile Arts, Inc, Dance with Miss Alice is not responsible for any injury or accident outside any location where classes, camps, parties or events take place. I hereby consent to my child’s participation in the activities by Etoile Arts, Inc. Permission: I authorize Etoile Arts, Inc to take and publish videos and photos of my child, for print and digital communications, to be used in media and marketing, devoid compensation. I understand that upon written request, my child will abstain from pictures or videos to be used in this manner.

Agree

Just one more step....You’ll get two for $20 when you try a class with a sibling or friend!

We cannot wait to meet your little dancer! We can’t wait to inspire a love of all things dance….

First Class Special

Dance Class Membership 2019-2020