Take a Class Register Summer & Fall Classes Schedule Summer Camps Parties and Events Instructors Media Training Well, Training Safely Injuries Registration Form Registration MDG Registration Form Season * Student’s Name * Registration date Date of Birth * Gender * MaleFemaleNon - Binary Pronouns * Parents' Names (only if under 18 yrs of age) Emergency contact name & cell number Home Phone * Cell Phone * Preferred number * Home Cell Home Address Medical Concern (if applicable) Email * Initials * Privacy Policy Monica’s Danz Gym Inc. (MDG) has a privacy policy regarding the collections, use, retention, disclosure and disposal of personal information including email address. This policy is available at MDG. I consent to give MDG permission to gather personal information for the following purposes: registration, communication about MDG’s programs, events, and activities, registration to dance conventions, festivals or competitions, in case of a medical emergency, when necessary for insurance coverage, managing insurance claims and conducting insurance. Signature of Participant/Guardian * signature keyboard Clear Photograph Privacy Policy From time-to-time MDG takes photo and/or video footage of students either professionally in performance, or simply for educational or advertising purposes. I consent to having the participant’s photo provided to media (if applicable), for educational purpose, or ongoing MDG advertisement (i.e. web site). Signature of Participant/Guardian * signature keyboard Clear Name of Participant * Date Please check applicable level of aerial apparatus training: * Beginner (0-1 yr) Recreational Experienced (2-3 yrs.) Intermediate (4+ yrs.) Advanced Experienced (with Momentum Performance team or 5+ years of experience) Drop-in Class, date of class * Payment * Regular Classes * Payment * Captcha Submit If you are human, leave this field blank. Δ Home Classes Register Fall Classes Summer Camps Schedule Parties and Events Class Fees Momentum About Us Photos/Videos Performances Booking & Contact World Gymnaestrada About Studio Instructors In the Media FAQ Events/News MDG student Momentum Aerial & Acrobatic Troupe Contact
