July 13 - 16
Pacific Dance Center Studios, 9596 Hamilton Ave., Huntington Beach, California, 92646
.
Jazz, Hip Hop, Ballet, Tricks/ Turns & Leaps, Contemporary, Technique, Conditioning & more.
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 PDC along with fee to reserve your spot.
For  more information email:  admin@coastcityballet.com
2015 Dance Summer Intensive
9596 Hamilton Ave - Huntington Beach, CA  92646
714-963-9771
admin@coastcityballet.com - pdc@coastcityballet.com
RELEASE OF LIABILITY-CONSENT TO PARTICIPATE
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 event, and authorize Coast City Ballet-Pacific Dance Center, its assigns and transferees to copyright, use and publish the same in
print 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 SUBMITTING THIS FORM  I AGREE TO THE ABOVE
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