Dance Dynamics of Hattiesburg Summer 2023

ONE STUDENT PER REGISTRATION FORM.

*Current Student Registration $15.00.

*New Student Registration is $25.00 and due at the time of registration.

Debit or credit card payments only. Cash or check payments for registration will not be accepted.

Student's Name *

Student's Birth Date * +

Name student goes by (if different from above)

Level or Grade In School Starting July/August 2023 *

Previous Dance / Tumble Experience *

Allergies / Injuries That May Restrict Student *

Parent's Name *

Email Address (ALL studio updates are emailed. Please make sure this info is correct.) *

Additional email recipient: (optional)

Cell Phone *

Address: *

City: *

State: *

Zip Code: *

Emergency Contact (Other Than Above Parent) *

Relation to student: *

Emergency Contact Phone *

SUMMER SESSIONS

DDH does not overfill classes. If a class no longer has availability, please EMAIL the studio at dancedynamicsms@gmail.com to be put on the class waiting list. Class enrollment is first come, first served.

Summer Session Pricing:

June/July Classes, $100 full session. Drop-in Rate: $20 per class

July Camps, $125 full session. Drop-in Rate: $30 per class

Registration fee due at the time of registration to hold spot.

JUNE CLASSES : Lil' Acrobat *Girl and boy classes.

JUNE CLASSES : Lil' Dancer *Girl and boy classes.

JUNE CLASSES : Lil' Heroes (Boys Only!)

JULY CAMP SESSIONS

T-SHIRT Size (Camp/class session participants will receive a t-shirt.) *

LIABILTY WAIVER AND RELEASE:

By signing below, I acknowledge and understand all of the studio policies and information above.

As a participant, or as a parent/guardian of a participant of Dance Dynamics of Hattiesburg, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume full risk of any injuries, including damages or loss which may be sustained as a result of participation in any activities connected with Dance Dynamics of Hattiesburg. I agree to waive and relinquish all claims against Dance Dynamics of Hattiesburg and its faculty members from any and all claims resulting from participation in the program. I acknowledge the contagious nature of COVID-19 and other contagious diseases and viruses and voluntarily assume risks that I and/or my child(ren) may be exposed to or infected by COVID-19 by attending and participating and that such exposure or infection may result in personal injury, illness, permanent disability or death. I understand by signing below that I RELEASE AND HOLD HARMLESS Dance Dynamics of Hattiesburg their staff, participants, owners, with the respect to any and all illness, disability, death, or loss or damage to person or property, whether arising from the negligence of releasees or otherwise to the fullest extent permitted by law.

Full Parent Agreement (Click Here)

*

I have read FULLY and understand Dance Dynamics's Summer 2023 Parent Agreement.

I understand that registration fee is non-refundable.

Parent's Name *

Parent Signature *

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Payment

New Student Summer Registration Fee $25.00

Current Student Summer Registration Fee $15.00

Full summer fee balance will be invoiced via email 2 weeks prior to sessions. Fees are due in full one week before sessions begin.