_______
__________________________________________
Date of Birth Gender
Parent/Guardian (if under 18)
Contact Information
Home Phone Mobile Phone Work Phone Email
Emergency Information
Parent’s Employer (Mandatory) Contact Number at Work
Secondary Emergency Contact Relationship to Student
Medical History
- Please list past injuries, medical problems, or
allergies:________________________________________________
_______________________________________________________
Background Information:
What is your previous dance experience?
What is your goal as a dancer?
What do you want to be when you ‘grow up’ (What is your
area of professional interest)?
FEES:
Membership fee: $20.00/yr –Due upon registration
and every January.
Monthly fees: $31/month. Due 1st of the month. Workshops are extra.
Please read and initial the following statements:
____
All persons intending to drive to and from
performances must have proof of insurance, a valid driver’s license and must
obey all applicable traffic laws. If any of the above conditions are broken,
you will not be allowed to drive and or transport
other students to and from GFDP sponsored events.
I
understand that there are fees associated with the services that GFDP provides
and I agree to pay fees for all services that I order and/or are
rendered to me by the GFDP.
Release of
Liability
I ________________________Parent/Guardian of _____________hereby
release Grupo Folklórico del Pueblo,
it’s Independent Instructors, and it’s Board of Directors, of all liability due
to any injuries and or accidents incurred during practice, rehearsals and
performances which includes travel to and from.
Student Signature________________________
Date_____________
Parent Signature_________________________
Date______________
