Health Waiver

Thank you so much for taking 2 minutes to fill out this form.
We look forward to dancing with you soon! 

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First and Last name
How did you hear about us?
Have you ever taken Dance or movement classes before?
Do you have any of the following conditions?
If you answered 'YES' to any of the health questions; I agree to take medical guidance before attending the dance class.
I agree to monitor my own response to the dance class, take rests when required, ensuring I listen to my own body and only push as far as I am comfortable with.
Name and Phone number
I agree for Renata Commisso to take captured photos and videos of myself and/or child or legal ward. I understand that the photo/video will be retained by Renata Commisso on their electronic database with the intention that it may be used on publicly available promotional material issued from time to time. I am aware that I may request a copy of the photo(s) that I/ my child/legal ward is in.
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