Registration

Please complete the below form to register for Fall 2019 classes. More details available here.

Please see below for payment options.

Student Name

First Name

Last Name

Student Grade & Age

We will use this when registering as a team at local competitions.

Parent or Guardian Name 1

First Name

Last Name

Parent or Guardian 1 Phone

(###)

###

####

Parent or Guardian 1 Email Address

We will use this email to send weekly updates.

Parent or Guardian Name 2

First Name

Last Name

Parent or Guardian 2 Phone

(###)

###

####

Parent or Guardian 2 Email Address

Name of Emergency Contact

First Name

Last Name

Phone # of Emergency Contact

Class Registration

Please select which class(es) you would like to register for and payment option.

Will you join for additional "team preparation" practice the final 4 classes?

The last 4 classes of the fall we will add an additional 30 minute practice for team skills to build on in the spring. Do you anticipate participating?

How would you like to pay?

General Release

I hereby release High Peaks Twirlers, Kristina Getty, or her agents or employees, heirs, successors and assign, from any liability or claim of student, or student's parent or legal guardian, arising out of any injury or accident resulting from normal class activity or student negligence. I understand that there are inherent risks in any physical or athletic activity and the student and parents or legal guardian acknowledge this. I hereby agree to indemnify and hold harmless High Peaks Twirlers, Kristina Getty, or her agents or employees, heirs, successors and assign, against any liability, claim or expense, including attorneys' fees and costs, arising out of any claim or suit with respect to the actions of students while a student at the studio or any injuries or claims occurring during the study of baton and dance at the studio.

I agree

I do not agree

Photo & Video Release

I understand that photos and video of students may be used both online and in print for advertising purposes and hereby grant permission.

I agree

I do not agree

Class Policies Acknowledgement

Please acknowledge you have read and understood the High Peak Twirlers class policies: http://www.highpeakstwirlers.com/class-policies/

Yes, I have read the class policies.