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Welcome to the Arts in Action Online Registration Form. Please note that registration is not complete until applicable registration fees and tuition are paid. Required spaces are marked (*). |
| Your name*: |
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| Age*: |
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| Birthdate*: |
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| Name of Parent: |
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| E-mail*: |
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| Address 1*: |
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| Address 2: |
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| City*: |
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| State*: |
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| Zip*: |
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| Telephone Number*: |
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| Emergency Contact Name*: |
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| Emergency Contact Telephone*: |
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| Please Check All Classes Of Interest |
| Precious Movements (Age 2) |
Creative Movements (Age 3-4) |
| Tap (Ages 3-4) |
Pre-Ballet (Ages 5-6) |
| Tap (Ages 5-6) |
Kids' Fitness |
| Boys' Tap |
Boys' Jazz |
| Drama (3rd-5th Grade) |
Ballet/Jazz Combo (Ages6-8) |
| Tap (Ages 6-8) |
Drama (6th Grade-High School) |
| Ballet/Jazz Combo (Ages 8-10) |
Tap (Ages 8-10) |
| Ballet Intensive (Ages 8-11) |
Ballet II (Middle School) |
| Jazz (Middle School) |
Tap (Middle School) |
| Boys' Jazz (Middle School) |
Pre-Pointe (Ages 10& Up) |
| Pointe (Ages 12& Up) |
Lyrical Modern (Ages 12& Up) |
| Jazz (High School) |
Tap (High School) |
| Ballet III (High School) |
Tap (Adult) |
| Adult Fitness |
Adult Worship Dance |
| "4th Wall" (Touring Performing Arts Ministry) |
"Lambs of Light" (Touring Performing Arts Ministry) |
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| Please carefully read the Waiver Of Liability below. By Clicking the Box "I Agree" you are agreeing to the terms stated within the Waiver of Liability. |
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Waiver of
Liability |
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By Clicking "I
Agree" below this box, you are agreeing to the waiver of Liability. |
| I, for myself, my executor, my
administrator, my heirs, and assigns, do hereby release and discharge
Arts in Action, Inc., including the board of directors, agents,
instructors, each director of each program, volunteers,
choreographers, employees, and anyone who supervises a class or event,
from any and all personal injury, damages, demands, or actions,
whatsoever in any manner arising or growing out of participation in any
Arts in Action program or activity
I attest and verify that I have full knowledge of the risks involved in the programs offered by Arts in
Action, Inc. |
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I Agree |
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