Dance Choreography Recording Consent Form

Dance Choreography Recording Consent Form
Please complete this form to provide your consent for the recording and use of dance choreography sessions.
Participant's Full Name*
First NameLast Name
Participant's Date of Birth*
MonthDayYear
Date
Participant's Email Address*
example@example.com
Participant's Phone Number*
Please enter a valid phone number.
Participant's Address*
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
YesNo
Parent/Guardian Full Name (if participant is under 18)
First NameLast Name
Parent/Guardian Contact Number (if participant is under 18)
Please enter a valid phone number.
Dance Class/Session Name*
Date of Dance Class/Session*
MonthDayYear
Date
Emergency Contact Name*
Emergency Contact Phone Number*
Please enter a valid phone number.
Signature of Participant or Parent/Guardian*
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