Solo Applications

Name(required)

Surname(required)

Street Address(required)

City, State & Postcode(required)

Date of Birth(required)

Age as of January 1st 2018(required)

Grade in School(required)

Phone Number(required)

Email Address(required)

Classical Solo

Neo Classical Solo

Jazz Solo

Broadway Jazz Solo

Hip Hop Solo

Lyrical Solo

Contemporary Solo

Tap Solo

Song and Tap Solo

Song and Dance Solo

Vocal Solo

Please nominate your first and second preference for the teacher you wish to work with.(required)

Theatrical duo`s of Trio`s please nominate your style of dance and partner(s)

Please provide details of any medical Conditions or injuries we should be aware of.(required)

Please list 2 emergency contacts to which the participant may be released to in event of an emergency and the parents can not be contacted.(required)

I authorise any licensed physician to render necessary emergency treatment for injury or illness when neither parent can be reached will assume all financial responsability for such treatment, I acknowledge that the above participant must have his or her own ambulance insurance. I understand that cheerleading and or dance has an inherent danger in participation and in spite of all precausions and injury prevention injuries do occur. I further acknowledge that each participant has elected to participate in Signature Cheer & Dance Studio at their own risk and will not hold Signature Cheer & Dance Studio or its Staff, Instructors or Coaches liable for any and all injuries that may occur while participating in any cheer or dance related classes, camps, clinics, workshops, competitions or events. I the parent guardian of the above listed athlete hereby grant Signature Cheer & Dance Studio and its successors, the unrestricted right to use the above listed athletes first name, likeness, or appearance (photo`s and video`s) on any Cheerleading or Dance posters, calendars, tryout flyers, photographs, video`s, social media, website other similar promotional material in any form, content or medium to promote Signature Cheer & Dance Studio.(required)

Parents Full Name(required)

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