Adult/Parent Information

Adult/Parent Name/Email:

Caregiver/Nanny (If participating in class):

Preferred Phone Contact:

Address Infomation

Same as Home?

Emergency Information

Student Information

Child Name

Does the student have allergies, medical conditions or learning difficulties?

Lesson Information

Terms of Acceptance

  1. Hereby release and agree to indemnify and hold harmless BTR Performing Arts Academy, its educators, employees, liabilities, costs and expenses including solicitor's fees which they or any of them or my child may sustain or incur in any way arising out of my child's participation in any and all BTR Performing Arts Academy activities.
  2. Have read and fully agree with the Registration Policy.
 

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Simply make your choice by clicking on one of the buttons below!

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