error - 2024 REGISTRATION FORM - ABAKA DANCE ACADEMY

2024-2025 REGISTRATION

If you want your children to be involved in Armenian activities, learn about Armenian culture and build lasting friendships, then Abaka Dance Academy is the place for them! Through the art of dance they will be exposed to Armenian music, language and all things Armenian!

REGISTRATION FORM INSTRUCTIONS:

EASY Registration > Now you can fill out just one application even if you are registering multiple students! If registering more than one child, fill out the additional students section and submit just one application for all! see form for details

Once registration is complete, please click the "SUBMIT REGISTRATION" button and you will be directed to the payment page. Do not click on SUBMIT more than once.

Email us at [email protected] with any questions!

IMPORTANT:: ONCE YOU CLICK ON "SUBMIT" REGISTRATION

REGISTRATION FORM 2024-2025

STUDENT INFORMATION

* Indicates required field

Student Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Date of Birth *

Current Age *

Name of school and grade level for 2024-2025 year *

Medical Conditions/Allergies? *

ABAKA Class that your student will attend: *

Registering multiple students? Continue below. If not, skip to "PARENT INFORMATION" section.

2nd Students Full Name (if applicable) *

2nd Students Current Age *

2nd Students Date of Birth *

2nd Students School and grade for 2024-2025 year *

ABAKA Class your 2nd student will attend *

2nd Students Medical Conditions/Allergies? *

3rd Students Full Name (if applicable) *

3rd Students Date of Birth *

3rd Students Current Age *

3rd Students School and grade for 2024-2025 year *

ABAKA Class that your 3rd student will attend: *

3rd Students Medical Conditions/Allergies? *

PARENT INFORMATION

Parent Name (First, Last) *

Parent Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Emergency Contact Name and Relation *

Emergency Contact Phone *

Secondary Emergency Contact Name and Relation *

2nd Emergency Contact Phone *

LIABILITY WAIVER: As parents or legal guardian of this child(ren), I hereby consent to aforementioned participating dance and related activated with ABAKA. I recognize that potentially injuries can occur at any activity involving motion, including dance and related activities. I understand it is the express intent of ABAKA to provide for the safety and protection of my child(ren) and in consideration for allowing my child(ren) to use these facilities, I hereby forever release ABAKA, its officers, employees, and teachers for all liability for any and all damages suffered by my child(ren) while under the instruction, supervision or control of ABAKA or its employees. As parent or legal guardian of the aforementioned person, I hereby agree to individually provide for the possible future medical expenses, which may be incurred by my child(ren) as result of any injury, sustained while participating in dance class or related activities at ABAKA. This acknowledgment of risk and waiver of liability, having been read through thoroughly and understood completely, is signed voluntarily as to its content and intent.

Do you accept? *

I accept

Signature (Full Name) *

Date *

I, as the parent or legal guardian of this child(ren), grant ABAKA DANCE ACADEMY my permission to use photographs or videos of my child(ren) for any legal use, including but not limited to: PR, copyright purposes, advertising, and web content.

Do you agree? *

I agree I disagree

Signature (Full Name) *

Date: *

SUBMIT APPLICATION