Dance Dynamics, Inc

Traci Monroe Weaver123 Capcom Ave., Suite 107

Director              Wake Forest, NC 27587

        919-554-0036

                  www.dancedynamicsinc.com

Miracles in Motion Registration Form

CLASSES ARE Registering for

NEW SEASON 

2011-2012 Registration Form

By submitting this form, I authorize Dance Dynamics, Inc. to contact me in the event of an emergency and, if I am unavailable, to treat my child with the medical attention they deem necessary.  I understand that dance is a physical sport which may cause physical injuries and I assume the risks.  I grant Dance Dynamics, Inc. permission to record the participation of this student on video and by photograph and to use these recordings for promotional use on the website www.dancedynamicsinc.com, in print, and at other Dance Dynamics, Inc. functions.

Please see the Dance Dynamics, Inc. calendar for important dates.

Home Address including City & Zip

School Grade if applicable    PreschoolK1st2nd3rd4th5th6th7th8th

Phone Numbers Home Cell Emergency/Cell

Email Address

Please list who is planning to bring the student to class. Contact Information

Class OptionAges 3-8yr  Friday's 4-4:45pmAges 9-18yr  Friday's 4:45-5:30pm

Please share any information about your child's situation/ condition that will help us work with him or her.

Please share any information about ways to work with your child that might help us make the class more successful.