Registration – Vedanshi Dance Academy

Registration Form

Student's First Name *

Student's Last Name *

Student's Birthdate *

Parent's First Name *

Parent's Last Name *

Parent's Contact Number *

Parent's Email Address *

City *

State/Province *

Class Type *OfflineOnline

Dance Style *

KathakSemi ClassicalBollywoodEvent Choreography

Event Name *0 / 100

Please list any allergies or medical conditions we should be aware of :

(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for registered student’s death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: Vedanshi dance Academy LLC, and Diksha Soni and/or their directors, officers, employees, volunteers, representatives, and agents. *

I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE Vedanshi dance Academy LLC, and/or Diksha Soni from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise. *

Electronic Signature. Please print your name below *

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Registration Form

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