Registration

METTS Dance
Registration 2008-2009

Student's Name			__________________________________________________					DOB: _________________
			Last		First
Father's Name			__________________________________________________					Work Phone:_________________

Mother's Name			__________________________________________________					Work Phone:_________________

Home Address			__________________________________________________					Home Phone:_________________

City			______________________			State	NY	Zip:___________________

E-Mail Address			__________________________________________________

Medical Insurance			_______	Yes	______	No	Company	_______________________

Medical Problems:			____________________________________________________________________________

			____________________________________________________________________________
Release:		I hereby consent to have my child/ward participate in programs offered by METTS Dance. It is hereby agreed that I, my child(ren) adopted or otherwise, my executors, waive and release all rights and claims for damages that I may have at any time against METTS Dance, its representatives whether paid or volunteer for any injury or damages in connection with the dance program or activities related to METTS Dance.



		I, also for the personal protection of the child(ren) give the right to METTS Dance to summon assistance should an injury occur. All immediate First Aid is conducted by the local Fire Department, who have a trained staff for this purpose. If necessary, I authorize the child(ren) to be taken to a local hospital if I cannot be reached by phone.


Parent's Signature:			_________________________________________________					Date:__________________

		I have read the policies and proceedures outlined in the METTS Dance brochure and agree with its contents. Any questions about payments, late fees, and disciplinary action has been discussed with me. My signature below states my understanding of these policies.


Parent's Signature:			_________________________________________________					Date:__________________
		We will be taking pictures of students to promote a positive image of the studio throughout the year. We will be posting these pictures on the web site (www.mettsdance.com). Pictures will be taken at, but are not limited to: Competitions, Recital, and regularly scheduled classes. Please select one of the following and sign.


	_____	I DO consent to having pictures taken				______	I DO NOT concent to have my picture taken
Parent's Signature:			________________________________________________					Date:__________________