Registration — Cooper River Ballet

Registration & Release Form

Student’s Name

First Name

Last Name

Date of Birth

MM

DD

YYYY

Parents/Guardians Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email

Emergency Contact & Phone

Does the student have any ailments or restrictions?

YES

NO

If YES, please explain:

How did you hear of Cooper River Ballet?

Did someone recommend you? If yes, please tell us who:

Has the student enrolling had previous training? If yes, please describe style, length, and previous schools:

Release Form

By signing this release form, I agree to pay tuition on classes registered for before classes begin and that no refund or credit is given for dropped or missed classes. By signing this form, I state that I have read all of Cooper River Ballet’s policies and dress codes and determine that I understand, agree with, and completely support all of the policies. By signing this form, I recognize that I understand Cooper River Ballet has an equipped Pilates Studio on site and that students are not permitted to touch the equipment unless under the supervision of a Pilates instructor. I recognize that if my child is injured as a result of handling the Pilates Equipment without supervision that the directors, owners, and instructors of Cooper River Ballet are not liable for said injuries. By signing this form, I understand that I have enrolled (STUDENT’S NAME LISTED FORM ABOVE AND/OR BELOW) in a program of strenuous activity offered by Cooper River Ballet, LLC. I affirm that the student is in good physical condition and does not suffer from any disability that would prevent or limit participation in this program. By signing this form, I release Cooper River Ballet, LLC, its owners, and its instructors from any claims, demands, or causes of action from the student’s participation in the dance program. I also release Cooper River Ballet, LLC, its owners, and its instructors from any liability due to injury, soreness, or illness, however caused, occurring before, during, or after participation in any of the programs offered by Cooper River Ballet, LLC, while in the vicinity of Cooper River Ballet, LLC, or in any activity sponsored, represented, or organized by Cooper River Ballet, LLC, the owners or its instructors for any reason. By signing, I affirm that I have read and fully understand and agree with the above waiver. DISCLAIMER: By typing your name below, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.

Download Registration Form To Print & Drop-In Studio