*CASH PAYMENTS ARE PREFERRED - Put cash in an envelope, write your dancers FULL NAME and put it in payment box in office
If you are unable to get the cash, we will accept:

If making an Electronic Payment, PLEASE put your Dancer’s FULL NAME, studio they attend, and what the payment is for in the notes or the Payment will be returned to you.

BUSINESS Venmo: @lewistongidance
Please add a 3% Venmo Business Fee

New or Returning Student *

New

Returning

How did you hear about us? *

Student's Name *

First Name

Last Name

Date of Birth *

YYYY

Grade student will attend in the Fall *

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Email *

Which studio are you registering for? *

Classes Student Would Like To Take *

Class schedule can be found on the Summer page.

Toddlers - Session 1

Minis - Session 1

Juniors - Session 1

Seniors -Session 1

Toddlers - Session 2

Minis - Session 2

Juniors - Session 2

Seniors - Session 2

Medical Conditions, Allergies, or Disabilities

Misc Info

Refer a Friend - Please Note Who Referred You, Special Requests, Etc

Photo Release *

I hereby grant to Lewiston/Grand Island Dance Centers’ the right to photograph my dependent and use the photo and or other digital reproduction of him/her for publication and advertising processes, whether print, digital or electronic publishing via the Internet.

Yes

Liability Release *

Lewiston Dance Inc. Hold Harmless Agreement In consideration for my child being permitted to participate in the Lewiston Dance Inc. program (referred to as “Lewiston/ GI Dance Centers”), I/Wethe parent(s) and/or legal guardian(s) of the dancer agree to the following provisions: Acknowledgment of Risks: I/We understand that there are numerous risks associated with participating in dance activities, including those risks present during classes and activities, on the premises before, during, and after various classes and events, as well as in travel to and from the Lewiston/ GI Dance Centers and various venues of performance. Some of the specific risks include the placement of unusual stresses on the body, falls and tripping which may lead to accidents resulting in, but not limited to, mild to severe bodily injury. I/We understand that the Lewiston/ GI Dance Centers cannot be responsible for any injuries or damages experienced by my/our child during her/his participation in Lewiston/GI Dance Center activities. Medical Care: In an emergency situation, when parental permission is not available, I/We hereby grant and give my/our permission for a staff member at the Lewiston/ GI Dance Centers to seek emergency medical treatment for my/our child. Media Relations: By signing the Agreement and Releases, I/We consent and give permission to the Lewiston/ GI Dance Centers, and those acting under its authority, to use the name or likeness of my child for the purpose of marketing the studio to the media. Release, Covenant Not to Sue, Waiver of Liability and Indemnification Provisions Parents (of Minors): I/We have read and clearly understand the terms of this Agreement. I/We give my/our permission for my/our child to participate in all Studio activities, including those described above. I/We also release and hold harmless the Studio, its officers, directors, agents and employees, and those acting under its authority, from all actions, claims and liabilities relating to my/our child’s participation in any and all programs. I further agree to indemnify and hold harmless and defend Lewiston Dance Inc., its teachers, officers, agents, and employees from injuries, damages and losses sustained by me or my child arising out of, connected with, or in any way associated with the activities of the program(s). I have read and fully understand the above program details and waiver and release of all claims.

Yes

Thank you!