Vibe Kidz Monday Class Enrollment

Vibe Kidz Monday Class Enrollment

Register your child for the Monday dance class and provide necessary contact and medical information.
Student Information
Child's Full Name

First NameLast Name
Grade
Classroom
Teacher
Parent/Guardian Information
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Emergency Contact
Emergency Contact Full Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Pickup Authorization
Pickup Person Full Name

First NameLast Name
Pickup Person Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Add another pickup person
Additional Pickup Person Full Name
First Name
Last Name
Additional Pickup Person Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Allergy or Medical Notes
VIBE KIDZ BEGINNER HIP-HOP CLASSES
PARTICIPATION WAIVER, RELEASE OF LIABILITY, AND EMERGENCY CONSENT

I, the undersigned parent or legal guardian, give permission for my child to participate in the Vibe Kidz Beginner Hip-Hop Classes program.

I understand that participation in dance classes and physical activities involves certain inherent risks, including slips, falls, collisions, muscle strains, sprains, and other injuries that may occur during physical activity.

I acknowledge that my child is physically able to participate in dance activities and that I am responsible for informing Vibe Kidz of any medical conditions, allergies, injuries, limitations, or special accommodations that may affect participation.

In consideration for being allowed to participate in the Vibe Kidz Beginner Hip-Hop Classes program, I voluntarily assume all risks associated with participation and agree to release, waive, and hold harmless Vibe Kidz, its instructors, staff, assistants, host schools, facilities, and affiliated parties from any claims, liabilities, damages, costs, or expenses arising from participation in the program, except in cases of gross negligence or willful misconduct.

In the event of an emergency, I authorize Vibe Kidz and its representatives to obtain emergency medical treatment for my child if I cannot be reached immediately. I understand that I am financially responsible for any medical expenses incurred.

I understand that Vibe Kidz Beginner Hip-Hop Classes is an afterschool dance program and is not a licensed childcare provider. Parents and guardians remain responsible for ensuring timely pickup of their child at the end of each class.

By signing below, I acknowledge that I have read, understood, and voluntarily agree to the terms above.
Signature
Parents: Do you allow your child to be photographed or videoed?
My Products
prevnext( X )
Monday Class 6- week Package
One class per week

$150.00

Total

$0.00
Payment Methods

Choose from one of the PayPal options to make your payment.
Should be Empty:

Vibe Kidz Monday Class Enrollment

Student Information

Parent/Guardian Information

Emergency Contact

Pickup Authorization

My Products

Payment Methods