ALL new students must fill out (parent/legal guardian must sign for children) and give to your teacher a Dynamic Dancing Informational/Waiver Form before their 1st class starts. You may get this form from your teacher at the 1st class meeting OR you may print it here.

Informational/Waiver Form New Student

Dancer's Name: ________________________________________ Birthday: _______________

Address: (Street)____________________________(City)_________________(Zip)__________

Phone #'s: (Home) ________________ / (Cell) ________________ / (Work)________________

E-mail: ______________________________________________________________________

Emergency contact: (Name) __________________(Relation)__________(Phone #)__________ 

For dancers under the age of 18, please fill out the following:

Mother's Name: __________________________________________________________

Mother's Phone #'s: (Home) _____________ / (Cell) _____________ / (Work) _____________

Father's Name: __________________________________________________________

Father's Phone #'s: (Home) _____________ / (Cell) _____________ / (Work) _____________

Class Info: (Title) __________________________ (Day) ____________ (Time) __________________

2nd Class Info:(Title) __________________________ (Day) ____________ (Time) __________________

 Today's Date:____________ Amount Paid:___________ Payment Method: cash/check/credit card

PLEASE SIGN - 2 times - ON NEXT PAGE

Agreement, Release from Liability, Waiver of Claims & Assumption of Risk

I agree to pay all fees for dance class enrollment before my first class meeting starts and I understand that no payment equals no dance class. I and my heirs, executors or other representatives, hereby indemnify, release and hold harmless Yvette Corvo Misner, Dynamic Dancing, and Dynamic Dancing with Yvette (its employees and instructors) from any and all claims of liability arising from any accident, personal injury, death, or property loss or damage sustained by myself, my child(ren) or any student who is a minor while participating in dance class(es), or while on off-site trips, performances, or activities. I understand that dance activities have inherent risks of injury and being fully aware of all risk, I consent to have my child(ren)/myself participate in the programs offered by Yvette Corvo Misner, and I accept full responsibility for providing adequate health and accident insurance coverage for both my child(ren)'s protection, as well as my own. By signing this statement I declare that my child(ren)/I is(are)/am in good health, with no physical conditions that might prevent participation in dance activities.

I have carefully read this Agreement, Waiver, Release, & Assumption of Risk and fully understand its contents. I understand that this is a release of liability and sign it of my own free will.

____________________________________________________________ ____________

Signature of Adult Dancer or Parent/ Legal Guardian of Underage Dancer Date

  Video and Photo Waiver

In the event that Dynamic Dancing with Yvette/Dynamic Dancing/Yvette Corvo Misner takes video footage and/or photographs of students during dance classes and/or performances, the video footage and/or photographs will be used for the purposes listed:

1) Photos of the dancers - without their names - will potentially be used for facebook and other social media networks, newspaper articles/ads, flyers, brochures, programs, the Dynamic Dancing web page, and displays at performances; and
2) Video footage of the dancers performing may be displayed at events, performances, and on the TV system in the main office of the Woodland Community Services Department.

We, the undersigned, give our permission for photos and video footage that includes ourselves and/or our children to be used in the manner stated above. We and our heirs, executors or other representatives, hereby indemnify, release and hold harmless Yvette Corvo Misner and Dynamic Dancing with Yvette for any misuse of said photos and video footage by third parties.