Dancer's Name *

First Name

Last Name

REGISTERING FOR: *

FULL PROGRAM (check this box only)

HIP HOP: 5:00-6:00PM

LYRICAL: 6:30-7:30PM (advanced stays until 8pm)

Parent Name *

First Name

Last Name

Parent Phone *

(###)

###

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KDA LIABILITY WAIVER & TALENT RELEASE *

By checking this box, I am electronically signing that I have READ, UNDERSTAND, AND AGREE TO KAILUA DANCE ACADEMY'S LIABILITY WAIVER & TALENT RELEASE

TUITION DEPOSIT REQUIRED *

A non-refundable 50% tuition deposit is required to reserve a dancer's spot in class. A registration form alone cannot guarantee a place in the program.

I understand and agree.