Online Registration Form

Registration Form

Below you will find our Online Registration Form. You can fill this out and click the submit button, and it will reach us right away. Please keep in mind, that due to preparations for seasonal performances, there are cut offs during the year for the semester.

Child Section

Please fill out your child's information here:

First Name *

Last Name *

Age *

Child's Grade *

Child's Birthdate *

Parent/Guardian Section

Please fill out the Parent/Guardian Information here:

First Name *

Last Name *

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Country *

Home Phone

Mobile Phone

Work Phone

Email *

Emergency Contact Information

Please tell us about your Emergency Contact

Emergency Contact Name *

Relationship *

Phone Number *

Medical Issues and Experience

Please list any Medical Issues, and tell us about your child's Dance Experience:

List any Medical Problems (if any)

Dance Experience

Release of Liability

Please read, check the box to acknowledge and sign below:

RELEASE OF LIABILITY

I, the undersigned parent or legal guardian, do hereby grant any permission for my son/daughter, a minor, or myself as a student, to participate in any and all classes, planned activities, and programs, offered by the Time and Tide Dance Company operated by Laura Brandon.

I do hereby release the Time and Tide Dance Company, Laura Brandon, its employees, and its representatives of all liability and claims of whatever kind and nature (including, but not limited to, injuries and death, and COVID-19) arising out of or resulting from the participation of my son/daughter/self in activities sponsored by the Time and Tide Dance Company.

I have read and agree to the Terms and Conditions and Privacy Policy. I agree that my typed name serves as my legal signature for this registration and release form.

SIGNATURE *

DATE *

By typing your full name above, you agree that this serves as your legal signature and is binding under applicable law.