Download CDP Membership Form
 
Huntington Beach, California

"Developing strong technique in the art of dance while enhancing the dancers' connection to the music and the art form."
 

Registration

MEMBERSHIP FORM :  Please print out the form and bring it with you when registering.

First Name:          Middle In: Date:
Last Name: Age:
Street Address:
City: State:
Zip Code:
Home Phone: e-mail:
Birth Date: Sex                                                M              F
Father’s Name:
Home Phone: Cell Phone:
Work Phone:
Mother’s Name:
Home Phone: Cell Phone:
Work Phone:  
Medical Information:  

Doctor’s Name:____________________________________

Phone #:  _________________________________________

Liability Disclaimer

Clifton Dance Project and the instructors are not liable for personal injuries or loss of, or damage to personal property for any and all participants or their guests.  Each student may decline to participate in any activity.  Please inform the instructor of any physical limitations you may have.  If you have any doubt as to your physical abilities, please consult with your physician before participating.

 I have read and agree to the Liability Disclaimer as stated above.

 

Signature __________________________________________________________

                 (must be signed by parent if under 18 years of age)

 
 
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