Coralyn J. Dance Class Registration

Please complete the form below to register for upcoming classes. All participants must complete the form prior to attending class. Waivers must be signed prior to attending a class.

First Name

Last Name

Phone

I fully release Coralyn Jones, it’s instructors, independent contractors, and all other associates from liability for harm, theft, or injury that me suffered by me and/or members of my family traveling to or from or participation in activities and programs sponsored by Coralyn Jones. I hereby acknowledge that I am voluntarily assuming full responsibility for all risks of physical injury arising out of active participation in a dance class or other dance related activities. I understand that there are no refunds for registration fees. Please type the statement "I fully understand the waiver and agree to all statements"

Date

Initials

Thanks for submitting!