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GBAD Registration Form 2010


Waiver of Liability

Great Bay Academy of Dance is not responsible for belongings left in the studio. Students dance at their own risk. We cannot be held liable for any injuries incurred to students and/or parents during classes or while on school premises. I agree that I will not hold Great Bay Academy of Dance, its owners, agents, and. or employees liable for any of the above circumstances.


Student Information


Student Name:

Address:

City:

State:

Zip/Postal:


Phone:

Birth Date:

Student Email:

Parent Information


Parent Name:

Day Phone:

Cell Phone:

Parent Email:


Emergency Contact Information


Name:

Phone:

Name:

Phone:


Please Indicate Class Choices:


Schedule and faculty subject to change

Please list any medical conditions (injuries, allergies, etc.) that we should know: