Form – Dance Registration Form – Little Star Fitness

Little Star Fitness Saturday Dance classes

Term 3: 5 Sept - 12 Dec

Parent Name

Child Name

Email Address

Phone Number

Location @St Ignatius Gymnasium (Adama van Scheltemaplein). Full term: remaining 10 weeks ; Half term: 6 weeks

Dance class selection (10am dance class fully booked)

Photo release *I hereby give permission for my child’s photo to be used for promotional/marketing purposes on behalf of Little Star Fitness

I GIVE permission
I DO NOT GIVE permission

I acknowledge that I understand there is a risk of injury. I understand that it is my responsibility to consult with a physician prior to and regarding any participation in these activities especially if health issues are a concern. I attest that my child is physically fit and has no medical conditions that would prevent their participation in these activities. I agree to inform the instructor(s) or staff of Little Star Fitness NL of any physical limitations, physical discomforts and/or injuries, and I take full responsibility for nondisclosure.

I have read and agreed to the Terms of Service

Subtotal €135.00

Total due €135.00

Little Star Fitness Saturday Dance classes

Location @St Ignatius Gymnasium (Adama van Scheltemaplein). Full term: remaining 10 weeks ; Half term: 6 weeks

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