Houston Dance Consortium
Join
Donate
Summer Clinic Registration
Events
Past Events
Contact Us
About Us
Shop
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Dancer's name
*
First
Last
Dancer's date of birth
*
What grade is the dancer in?
*
If between grades, list the grade the player will be in at the start of the next school year.
Number of previous years danced
If none, please enter NA.
Check all dance experience
Private Lessons / Studio
Competitive
Dance Team
Recreational
Other
N/A – New Dancer
Parent/Guardian Name
*
First
Last
Parent/Guardian Email
*
Parent/Guardian Phone
*
Please share any relevant Medical Conditions, (including Allergies):
Permission & Agreement
*
I agree and give my permission
As the enrolled participant and/or the parent/legal guardian of the enrolled participant/student/dancer, I agree and understand that dance/fitness training is a potentially hazardous activity. I recognize that there are risks inherent in dance training including but not limited to serious physical injury. Despite precautions, accidents and injuries may occur. By signing this release form, I/we (the dancer/student/participant and parent/legal guardian) assume all risks related to the use of any and all spaces used by Houston Dance Consortium. The participant/student/dancer hereby agrees to participate in activities of the Houston Dance Consortium and hereby agrees to indemnify and hold harmless Houston Dance Consortium, its instructors, officers, directors, partners, agents, contractors and employees against any liability resulting from any injury that may occur to the participant/student/dancer while participating in activities of the Houston Dance Consortium. The participant also agrees to indemnify Houston Dance Consortium for any damages incurred arising from any claims, demand, action or course of action by the participant/student/dancer. I/we will not hold Houston Dance Consortium, its instructors, officers, directors, partners, agents, contractors and employees liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes. Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by Houston Dance Consortium.
The enrolled participant/student/dancer authorizes any representative of Houston Dance Consortium to have the participant treated in any medical emergency during their participation in activities of the Houston Dance Consortium. Further, the participant and/or parent/legal guardian agrees to pay all costs associated with medical care, transportation for the participant/student/dancer.
Media Policy
*
I agree and give my permission
I do not agree
As the enrolled participant/student/dancer and/or the parent/legal guardian of the enrolled participant, I authorize Houston Dance Consortium and/or its representative(s), partner(s) agent(s), employee(s), or contractor(s) to photograph and/or videotape and use any photograph/media/likeness of me or my minor child for any purpose, including publicity, choreographic archives, promotional materials and/or any other reason deemed appropriate by Houston Dance Consortium.
I understand that in order to opt out of having my dancer’s photos released publicly, I must notify Houston Dance Consortium and request a change in status for “No Public Photos” be made to my profile. Once this change is made, your dancer’s profile will indicate to Houston Dance Consortium staff that no public photos should be posted.
and/or its representative(s), partner(s) agent(s), employee(s), or contractor(s) to photograph and/or videotape and use any photograph/media/likeness of me or my minor child for any purpose, including publicity, choreographic archives, promotional materials and/or any other reason deemed appropriate by Houston Dance Consortium.
I understand that in order to opt out of having my dancer’s photos released publicly, I must notify Houston Dance Consortium and request a change in status for “No Public Photos” be made to my profile. Once this change is made, your dancer’s profile will indicate to Houston Dance Consortium staff that no public photos should be posted.
Registering For:
*
Princess Dance Clinic (Ages 4-8) –
$25.00
Wicked Dance Clinic (Ages 8-13) –
$25.00
Kids Dance Camp (Ages 5-12) –
$125.00
Stripe Credit Card
*
Total
$0.00
Submit