Registration/Enrollment Form
“Para version en español favor de seleccionar aqui”

Today's Date:
First Name: Last Name:
Current Address
City: State: Zip
Telephone: Cell Phone:  
Email:
Occupation:
Date of Birth Sex:  
Medical Problems(if any)
Please explain in space below

In Case of an emergency, who should we contact?
Full Name:
Telephone:

"PLEASE READ THE FOLLOWING CAREFULLY"

I, the undersigning applicant of Santo Rico Dance, Inc, acknowledges that I am applying for instruction in Latin Dance, or any variation therefore, involving physical activity. I acknowledge that the school carries no insurance against injury to any of its students. As a condition to being admitted to the school as a student, I assume the risk of all injury and hold Santo Rico or its instructors and agents harmless from any and all liability (including attorney's fees and costs) for all claims, actions or damages, due to injuries suffered by me or caused to third parties by me arising out of activities involving Latin Dancing, or any variations therefore, whether occurring on the premises of the school or elsewhere, excepting only those claims, actions, or damages caused by the gross negligence or intentional act or mission of any of them.

Note: We are not responsible for lost or stolen property and/or membership passes. All entry-level applicants are subject to a $25 Registration Fee used toward the purchase of the school's basic level instructional video.
 
Electronic Signature Required: I agree to abide by the rules of the school and follow explicity all instructions given by the instructor during the course of my instruction..
 
* If you are under eighteen (18) years of age, a parent or guardian*
Parent/Guardian Electronic Signature Required: I, the undersigned, as parent or guardian of the above applicant, certifies that I have read the above application and consent to the applicant receiving the instruction applied for, and agree with the provisions of the contract for myself and above-mentioned applicant..
 
 
 
 
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