
Santa Barbara Movement Arts
s c h o o l of c o n t e m p o r a r y d a n c e
quality dance education
Modern Dance / Contemporary
BALLET FLOOR BARRE - a great warm-up, stretch, conditioning class for learning the principles and essential floor barre of classical ballet and its application to all standing classical movement. WEDNESDAYS 9 - 9:30. 30 min.
Registration Form:
Please print or scan form to mail, fax, email or bring it to class. Thank You!
Date _________________________
Semester (circle one)
Fall / Winter - Spring / Summer
Student’s Name Age Date of Birth
____________________________________
Parent or Guardian Names
1.) ____________________________________
Address ___________________________
Home Phone ___________________________
Cell Phone _____________________________
Email________________________________
Course______________________________
Day________Time_________Fee________
Emergency Contact:_____________________________
I ____________________________hereby agree to accept full responsibility for any personal injury, and hold harmless, Maria Rendina Frantz of Motion Theatre Dance Company and her associates and assigns, for any liability claim resulting from participation in dance classes, performances, rehearsals and related activities. By signing this form I acknowledge that I have read and fully understand this agreement.
Parent/Guardians
Signature
______________________________________
Date__________________________________
Make checks payable to MotionTheatre Dance Co., Inc. (a non-profit 501 (C) (3) corporation)
Photo Release Agreement
I agree to release the use of any photographic images taken of my child ____________________________________
(please print child’s name) created for Santa Barbara Movement Arts Dance Program will be used for the sole purpose of advertising for the school website, for magazines, ads, newspapers, brochures, programs, videos and other promotional materials of the Motion Theatre Dance Co. and for that purpose only.
Parent,Guardian,Signature
___________________________Date_____