July 24-26
Pacific Dance Center Studios, 9596 Hamilton Ave., Huntington Beach, California, 92646
.
Jazz, Hip Hop, Ballet, Tricks/ Turns & Leaps, Contemporary, Technique, Conditioning & more.11
Amazing instructors
Register online thru July 10th and receive a discount. Only prepaid students will maintain their spot.
Fill out and submit  the form below.  Or  print and bring to studio along with fee to reserve your spot.
For  more information email:  admin@coastcityballet.com
1
2018 Summer Workshop
9596 Hamilton Ave - Huntington Beach, CA  92646
714-963-9771
admin@coastcityballet.com - pdc@coastcityballet.com
Please fill and submit - For more information email: admin@coastcityballet.com
*Birthdate
*Student
Parent
if under 18
*Address
*Email
*Phone
F
Consecutive years of training
M
RELEASE OF LIABILITY
 I understand that my (my child’s ) participation is voluntary, and I agree that Coast City Ballet-Pacific Dance Center their
past, present and future officers, employees, contract teachers, agents, representatives, successors assigns, insurers  
are not liable for any harm, bodily injury, or damage that may occur.


 I grant to Coast City Ballet-Pacific Dance Center the right to take photographs and videos of me (my child) in connection
with the above-identified and/or electronically.  I agree that Coast City Ballet-Pacific Dance Center may use such
photographs and videos of me (my child) with or without my name and for any lawful purpose, including for example such
purposes as publicity, illustration, advertising, and Web content.

 I hereby release Coast City Ballet-Pacific Dance Center and their past, present and future officers, employees, contract
teachers, agents, representatives, successors, assigns, and insurers from any and all liability, loss, damage, costs,
claims and/or causes of  action, including but not limited to all bodily injuries, damages or loss of property arising out of
participation in classes or activities.      

 I understand this waiver may be used in a legal action against the undersigned and/or representative filing claims on
their behalf
                                                                                       
By signing and submitting this form I agree to follow Coast City Ballet~Pacific Dance Center Studio Policies.
*Signature
Please make your payment via the Pay Pal button below and then click the submit button to submit registration. Thank you
Summer Intensive 2018
* Required Field