Cell Phone for Text Messages
Email Address
I give permission to Kauai Dance Center for photographs & film to be taken
First Name
Last Name
Other Phone
Dance Class Level
I understand that my child is performing in a public event.
I understand that my child's image may appear in promotional material for Kauai Dance Center and dance program literature. I understand that I will not receive compensation for the use of the image(s)
Kauai Dance Center reserves the right to refuse dance classes to anyone.
Note: Disruptive behavior harms us all. Should we meet an unfortunate situation with a student or parent where the behavior causes a disruption of a class, and causes concern beyond what is reasonable to work with, the student & parent will be asked to leave the program.
Parent / Adult Signature
Student Signature
Sponsor Signature (if applicable)
Comments, Questions
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