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Parent/Guardian Information

Email

Parent First Name

Parent Second Name

Parent phone number

Student information

Student First Name

Student Second Name

Student date of birth

Does your child suffer from any medical conditions that we should be aware of? NoYes

Student Age Group

Agreements

I agree with the UpTop Dance Terms and Conditions Read UpTop Dance Terms and Conditions

During our dance classes and performances, we will be taking photos and videos that we may use for educational or marketing purposes. By attending our classes you agree for your child to be featured in our media. UptopDance commits to not using such media in any way that might be harmful towards our students.

Upon receiving trial date confirmation from UpTop Dance, I agree to attend the chosen free trial. I understand that not doing so could potentially prevent another child from participating due to limited capacity.