Registration

Please complete the below form to register for Fall 2018 classes.

 
Student Name *
Student Name
We will use this when registering as a team at local competitions.
Parent or Guardian Name 1 *
Parent or Guardian Name 1
Parent or Guardian 1 Phone *
Parent or Guardian 1 Phone
Parent or Guardian Name 2
Parent or Guardian Name 2
Parent or Guardian 2 Phone
Parent or Guardian 2 Phone
Name of Emergency Contact *
Name of Emergency Contact
Which classes are you registering for? *
Note: for credit card payments Kristina will send a request for payment through PayPal for Fall 2018. Payment can also be accepted through Venmo or the Cash app.
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.
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.