Registration Form

Submitted by admin on Tue, 11/27/2012 - 22:56

SOMA YOGA Open House: May 18-31
Classes by donation. Donations will go towards the businesses that operate out of Soma Yoga that are having to adapt and grow in these new times.

Summer 2020 (ONLINE) Registration open now
May 25-July 29
10 weeks, $100/$175
Register for one day a week ($100) and each week you can choose between the two classes offered on that day.
Register for two days per week for a discounted rate of $175, and you will receive all four class logins/passwords
classes listed in drop down menu

Click on the class drop down menu to register. After you submit the form you will receive an email with instructions for making payment and confirming your registration was received, usually within 2 business days. If you don't see it in your inbox, please check your junk mail.

DC=Instructor is Dakota Crist HS=Instructor is Hayley Shannon
DB=Instructor is Darrah Blanton

Class *

Student Name *

Date of Birth *

Month

Day

Year

Phone (Cellular) *

Phone (Work) *

Phone (Home) *

Phone (Emergency) *

Parents’ Names *

Address 1 *

Address 2

City *

Zip *

Email address *

Please describe any special needs or health history you would like me to be aware of

Release Form *

I agree to let my child participate in the dance program of Darrah Blanton, and hereby release Darrah Blanton, Dakota Crist and Hayley Shannon from liability for any injury my child may incur as a result of their participation.

Release signature *

Type the name of the parent or guardian completing the form.

Release Date *

Month

Day

Year

Photo Release *

Allow the use of photographs and/or video of my child

Please refrain from using photographs and/or video of my child

Periodically the website is updated with photos and/or video. Please indicate above whether you would allow photos and/or video of your child to appear online at www.darrahblantondance.com and to be used in printed materials for advertising purposes.

Refund Policy: Refunds/credits are not available after August 20 for fall classes, after November 15 for Winter/Spring classes, or after May 1 for Summer classes. Cancellations prior to these dates will incur a $50 cancellation fee per registration. *

I understand and agree to the refund policy.

How did you hear about us? *

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