Please complete the form with Sibling’s information

Only complete if you have already filled out a full registration with contact info, etc.

Dancer's Name *
Dancer's Name
Dancer's registered sibling(s)
Dancer's registered sibling(s)
After you have read the Class Schedule & Information Page select class or classes. *
Media Release *
I hereby give permission for Northwestern Studios to use photographs/videos of my likeness and my child’s likeness which includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of my child or myself for use in materials that include, but may not be limited, to printed materials such as brochures and newsletters, advertising, videos, and digital images such as those on the internet and social media. Parents or Persons who do not want to be included in promotional materials can opt-out at any time by sending an email to the school.
Release & Waiver of Claims *
I have chosen for myself or my child to participate in dance instruction given by Northwestern Studios. I acknowledge that I understand the nature of the activities my child will be participating in and that my child is in the proper physical condition and capable of participating in the related activities, understanding that Northwestern Studios is not in any way responsible for making such a determination. In consideration of my own and/or my child’s enrollment in any dance instruction program, I understand and agree on behalf of myself and/or my child, to release, hold harmless, and discharge Northwestern Studios from all claims, costs, liabilities, expenses or judgments, including attorneys’ fees and court costs for any occurrences in connection with any dance instruction. I assume all risks to myself and/or my child in connection with any instruction and further release Northwestern Studios and its owners and employees from liability for any injury sustained by myself or by my child while he or she is enrolled in any dance instruction program, including all risks reasonably connected with such activity whether foreseen or unforeseen. I understand that Northwestern Studios is not responsible for my child or other children under my supervision who are left unsupervised in the common areas and areas surrounding the dance studio and that Northwestern Studios will only be supervising my child when he or she is participating in scheduled dance activities, programs or instruction. I understand that Northwestern Studios is not responsible for personal property that is lost, damaged or stolen while I or my child is at or on Northwestern Studios property. I acknowledge and agree that it is my responsibility to maintain my own accident and health insurance coverage that provides adequate coverage for myself and my child participating in Northwestern Studios activities and that Northwestern Studios does not provide accident or health insurance for those participating in its instruction, activities or programs. By checking the Release and Waiver of Claims box I show of my intention to execute a complete and unconditional waiver and release of all liability pursuant to the terms herein, and agreement as to all terms and conditions contained above. I HAVE FULLY INFORMED MYSELF AS TO THE CONTENTS OF THIS RELEASE AND HAVE READ THE SAME PRIOR TO REGISTERING MYSELF OR MY CHILD.