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.Format: (000) 000-0000.
Participant's Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Are you under 18 years of age?
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.Format: (000) 000-0000.
Dance Class/Session Name
Date of Dance Class/Session
MonthDayYear
Date
Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Signature of Participant or Parent/Guardian
Powered by Jotform SignClear
Should be Empty: