Register

A completed Registration Form is required for all students who participate in Dance Daze® Davis classes. This form should be completed and submitted online before a child’s first class. There is no fee for submitting this form.

Please update this form at least once each year, before fall classes begin. Thanks!

Click the “Pay Now” button below to pay for your child’s Dance Daze® Davis classes! (A separate tab will open for this. For instructions on completing online payment please click here.)

(Davis, CA tax rate of 8.25% will be automatically applied to your payment.)

Child's First & Last Name(required)

Child's Date of Birth (mm/dd/yyyy)(required)

Private Lesson Request (Please provide requested dates, times, and desired style of dance.)

Child's Shoe Size(required)

Child's Shirt Size(required)

Child's Pants Size(required)

Any allergies or previous injuries? If so, please describe.(required)

Any special needs (behavioral, emotional, or physical) that require accommodations?(required)

Name of Child's School (or N/A)(required)

Child's Address(required)

Name & Phone Number of Child's Doctor(required)

Child's Medical Insurance Provider & Policy Number(required)

Parent/Guardian First & Last Name(required)

Parent/Guardian Email(required)

Parent/Guardian Phone(required)

Emergency Contact Name & Phone Number(required)

POLICIES AND TERMS: I agree to pay for my Dance Daze classes on time–before the first class or upon arrival. I understand that there is a $35 Returned Check Fee for any check that returns for any reason. I understand that there are NO REFUNDS for tuition, fees, or payments made to Dance Daze (unless Dance Daze cancels class and does not offer alternative makeup dates for the cancelled class). PARENT/ LEGAL GUARDIAN MUST TYPE NAME BELOW TO ACCEPT THE ABOVE TERMS.(required)

PHOTO & MEDIA RELEASE: By enrolling my child in Dance Daze programs, I am granting Dance Daze, Inc. the right and permission to use, re-use, publish, and republish photos and/or videos of me or my child in Dance Daze classes for promotional purposes in print and media formats. I understand that no personally identifiable information (such as the student’s name or school) will be used with these photos or videos. PARENT/ LEGAL GUARDIAN MUST TYPE NAME BELOW TO ACCEPT THE ABOVE TERMS.(required)

EMERGENCY RELEASE: In case of emergency, I understand that every effort will be made to contact the Parents/Guardians/Emergency Contacts at the phone numbers recorded on this form. I understand that it is my responsibility to contact Dance Daze if these numbers change. I give my permission to the physician selected by the instructor in charge to secure proper medical treatment for my child in case of injury. I hereby consent to emergency treatment of my minor child as a result of accident or injury. I further agree to pay any and all costs incurred as a result of said treatment. PARENT/ LEGAL GUARDIAN MUST TYPE NAME BELOW TO ACCEPT THE ABOVE TERMS.(required)

ASSUMPTION OF RISK/WAIVER & RELEASE OF LIABILITY/INDEMNITY: In consideration of my child’s participation in a Dance Daze® program, I acknowledge that I understand the risks of personal injury inherent in dancing, and I am willing to assume those risks for my child. I am voluntarily enrolling my child in a Dance Daze® program, and, in doing so, I am stating that I believe my child is in good health and in proper physical condition to participate in the program. I fully understand that this type of training involves risks of serious bodily injury including permanent disability, paralysis, and death. Having been informed of and clearly understanding the circumstances described above, I hereby agree to waive, release, protect, defend, indemnify, and hold harmless Dance Daze, Inc., its founder and director Saumirah McWoodson, and all Dance Daze agents (including teachers, contractors, volunteers, interns, management, and successors) from and against any and all liability, damages (including those caused or alleged to be caused by the negligence of the released party), expenses (including medical bills and legal fees) and/or claims of any nature whatsoever arising out of or in any way related to my child’s participation in Dance Daze® classes. PARENT/ LEGAL GUARDIAN MUST TYPE NAME BELOW TO ACCEPT THE ABOVE TERMS.(required)

Whom may we thank for referring you?(required)