Waivers & Policies | With Sonia Brown

Medical and registration form

ALL INFORMATION WILL BE KEPT CONFIDENTIAL

Full Name

Address

How Did You Hear About The Class?

Contact Telephone Number

In Case of Emergency, Please Provide a Name and Contact Number

Are there any medical issues which may affect your participation in a dance class that we need to be aware of? Or should something happen to you, is there anything that might be useful information when seeking emergency medical care?

I confirm that I have completed the above questionnaire to the best of my ability and that I have provided accurate information regarding my current health status. I take it upon myself to discuss any changes in my health with the teacher and my Doctor. I understand that any dance/exercise class has certain risks. I understand that the degrees of risk depend on my health and physical fitness. I am voluntarily participating in classes with Sonia Brown, and will immediately discontinue any activity if I feel any symptoms of distress or discomfort, and will notify the tutor.

I confirm that I have read, understand and agree to the privacy agreement.View privacy agreement