Drop in $15.00 - Montlhy $58.00
Broadway Jazz
Thursday -  7:30 p.m.
Intermediate
Broadway Tap
Thursday - 8:30 p.m.
Intermediate
Beginners Welcome
Adult Cardio Hip-Hop
Thursday 6:30 p.m.
Online Registration
9596 Hamilton Ave - Huntington Beach, CA  92646
714-963-9771
Please fill and submit - For more information email: admin@coastcityballet.com
* Required Field
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Name:
Name:
Parent
if under 18
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DL #
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Address:
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Email:
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Email:
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Class:
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 submitting this form I agree to follow Coast City Ballet~Pacific Dance Center Studio Policies.
Please make your payment via the Pay Pal button below and then click the submit button to submit registration. Thank you
Cardio HH - Bdwy Jazz or Tap