Dance Class Registration & Pricing

DANCE CLASS REGISTRATION & PRICING

Contact Information

* Indicates required field

Participant Name *

First

Last

Parent Name (If Applicable) *

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Class Selection

Dance Classes *

Tuesday 8PM | Adult Hip Hop (13+) Friday 5PM | Contemporary (Waitlist) Friday 6PM | Ballet (Waitlist) Friday 7PM | Breakdancing (Waitlist)

Payment Information & Authorization

Note: You will NOT be charged until your registration is confirmed.
Fees: $25 Annual Registration Fee (billed annually) | $36 Late/Return Fee (if a payment is returned or declined)

Rate Selection *

Name As Shown On Card *

First

Last

Card Number *

Billing Zip Code *

Expiration Date *

CVV *

Any other questions, comments, or concerns? *

Waiver, Media Release & Consent

Waiver: In the event I am injured or suffer any short-term, long-term Physical harm or death, by signing below, I release Kontagious Performing Company, KPC LLC, its extension teams and affiliates: Kontagious, Toxik, Kure, Angels, Sick, Lynnwood Recreation Center, Shoreline Recreation Center, Seattle Dance Academy of Arts and Sciences (SAAS), eXit SPACE, theNEST, and any additional locations and/or its organizers, promoters, instructors and participants from any and all liabilities now or in the future including but not limited to medical, dental, hospital, paramedic or ambulatory care.

Media Release: I agree to being videotaped and photographed. I understand that this footage may be shared with the general public in various types of media (television, ads, internet, etc.). I will allow Kontagious Performing Company, extension teams and affiliates: Kontagious, Toxik, Kure, Angels and Sick to use this content for marketing and advertising purposes related to the website and the promotion of the company. I am at least 18 years of age. If not, I have parent/ guardian knowledge and consent of my participation.

By submitting this form, I acknowledge that the information entered is true, correct, and current and I have read, understand and agree to all sections that are listed below.

"Contact Information"
"Class Selection"
"Payment Information & Authorization"
"Waiver, Media Release & Consent"

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