Registration

Welcome to the KeyHeart Dance online registration and enrollment. To register, complete all the information below, then select Submit Registration. After you register, you will receive a confirmation email.

Contact Name

Name *

Email *

Phone *

Relationship Type: *

Emergency Contact Info *

Student 1

Student 1 Name

Student 1 Age

Student 1 Birth Date

Student 1: Physical or Medical Conditions (e.g., asthma, allergies)

Put NA If None

Student 1: Previous Dance Experience

Student 2

Student 2 Name

Student 2 Age

Student 2 Birth Date

Student 2: Physical or Medical Conditions (e.g., asthma, allergies)

Put NA If None

Student 2: Previous Dance Experience

REQUIRED POLICIES

Release of Liability *

I've read below and agree

As the legal parent or guardian, I release and hold harmless KeyHeart Dance, its owners, and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of KeyHeart Dance, its owners, and operators.

Medical Emergency *

I've read below and agree

The undersigned gives permission to KeyHeart Dance, its owners, and operators to seek medical treatment for the participant in the event they are not able to contact a parent or guardian. I hereby declare any physical/mental problems, restrictions, or conditions and/or declare the participant to be in good physical and mental health. I request that our doctor/physician be called and, if necessary, that my child be transported to the specified hospital. Important: You must include the physician's name, phone number, and specific hospital on your Account Page under 'My Students'.

Refund Policy *

I've read below and agree

KeyHeart Dance maintains a strict no refund policy for all payments, including but not limited to, payments for monthly class subscriptions. Missed classes for any reason, including student absence, will not be eligible for refunds.

Release of Photo/Video *

I've read below and agree

As the legal parent or guardian, I release and hold harmless KeyHeart Dance to use photos and/or videos taken during dance class or events in promotional advertising or slide shows.

I Agree To The Above Statements: 12/22/2024 *

Clear

Sign Your Name Above

Questions Or Concerns: