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Miss Becky's Dance Studio

Dance with Miss Becky

414-425-5715
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Registration

Class Registration Form
Participant's Name(Required)
MM slash DD slash YYYY

Class information

Parent Information

Parent / Guardian Name(Required)
Parent / Guardian Address
Parent / Guardian Name 2

Emergency Contact Information

Please List 2 Emergency Contacts
Name
Name

Consent and Waiver Information

Participant Liability Waiver and Hold Harmless Agreement(Required)
As a participant or participant’s parent/legal guardian, I understand that by participating in any class, rehearsal, or performance, there is a possibility of physical injury. I, therefore, agree to assume all risks of such injury which might occur during any classes, rehearsals, or performances of Miss Becky’s Dance Studio or any related Miss Becky LLC activity. I agree to waive any and all claims I may have arising out of, connected with, or in any way associated with the activities of Miss Becky’s Dance Studio.

I do hereby fully release and discharge Miss Becky’s Dance Studio, Miss Becky LLC, its owners, employees, assistants, volunteers, and instructors from any and all claims from injuries, damage, or loss which I or my minor child may have or which may occur as a result of participation in Miss Becky’s Dance Studio activities.

Referral and Registration Information

*$25 Annual Registration Due for all Technique/Semester Class with Registration. Register by 9/1 and you can take $10 off your registration fee. 1st month’s Payment or Semester Payment also due at time of Registration. *Register for a specialty class by 9/1 and you can take $5 off. * You will receive a confirmation and receipt when your class has met the minimum requirement. If you would like to pay by credit card there is a $3 transaction fee.
  • Home
  • Classes
    • Class Descriptions
  • Registration
  • Students
  • Instructors
  • Calendar
  • FAQs
  • Testimonials
    • Add Testimonial
  • Contact

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Miss Becky's Dance Studio 5158 S 108th St, Hales Corners, WI 53130
414-425-5715
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