Serving the Community since 1994


Classical Dance Center  Registration Form
Please fill out the following information and attach the
$20 Annual Administration Fee (per family per year) to Pre-Register for Fall Classes

Student (s) Name___________________________________________


Age __________Date of Birth_________________

Student (s) Name___________________________________________

 Age __________Date of Birth_________________
 
Address_________________________________________________


City________________________ ___________Zip______________

Home Phone__________________ Cell Phone__________________

E-Mail Address___________________________________________

Parents Last Name (if different) ______________________________

$20.00 Pre-Registration Fee Paid by: (circle one)      Check     Cash    Credit Card

for credit card payment: _ _ _ _ - _ _ _ _ - _ _ _ _ - _ _ _ _   Exp_ _ /_ _

Please List Classes Below

Class                                     Day                                         Time
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please list any other additional classes on the reverse side.
 
Insurance waiver must be signed to participate in classes - I give my permission for CDC staff to call doctor in the event of an emergency.  I recognize the risks of injury inherent in any exercise program and I am participating in the CDC’s program upon the express agreement and understanding that I am waiving and releasing the CDC from any and all claims, costs, liabilities, expenses, judgements, including attorney fees and court costs(herein collectively “claims”) arising out of my participation in the CDC’s instructional program, performances and/or rehearsal participation and any and all participation in any even or program given or sponsored by the CDC or any illness or injury resulting there from.  I hereby further agree to indemnify and hold harmless the CDC from and against any and all such Claims except claims proximately caused by gross negligence of willful misconduct of the CDC.
 
Parent Signature____________________________ Date____________

Please return your Pre-Registration Form and $20 Administration Fee

to the Studio Desk

If you miss us, drop it in the mail slot or mail to: 

494 El Camino Real, Tustin, CA 92780  714.573.1411

Check us out online at www.classicaldancecenter.com

Classical Dance Center