WordPress Dance Membership Registration Form

First Name*

Last Name*

Gender*

MaleFemaleN/A

Date of Birth*

Mobile Number*

Email*

Address*

Address Line 1

Address Line 2

City

State or Region

Country

Zip

Membership Type*

Full Membership (Unlimited classes, priority booking)Part-Time Membership (Limited classes per week)Drop-In Membership (Pay per class)Family Membership (Discounts for multiple members)

Membership Duration*

MonthlyQuaterlyAnnual

Preferred Class Times*

MorningAfternoonEvening

Any health conditions or allergies?*

YesNo

If yes, please specify

Additional Notes or Requests

Terms and Conditions

I authorize the dance studio to seek medical treatment for the participant in case of an emergency.

I agree to abide by the rules and policies of the dance studio. I understand that there are risks associated with participating in dance activities and agree to release the studio from liability for any injuries sustained during participation.

I have read and understood all the instructions/terms and conditions.