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To print use print command, Ctrl+P on your keyboard.-----------------------------------------------------------------WEST HAWAII DANCE ACADEMYREGISTRATION FORM                                           StudentName__________________________ Age _______________ Birth date _________________________Address ___________________________________ Home Ph. _________________________________City/State ____________________ Zip _____________School ___________ Grade_____________Father's Name ________________________ Mother's Name _________________________________Address ______________________________ Address _______________________________________City/State/Zip _______________________ City/State/Zip ________________________________Phone(h) ___________ (w)______________ Phone(h) ________________ (w)__________________Employer _____________________________ Employer ______________________________________Adult Responsible for Payment ________________________________________________________Address, If Different from Above _____________________________________________________Any Heath Problems? _________________________________________________________________In case of emergency, please notify __________________________________________________Preferred Classes ____________________________________________________________________I have read West Hawaii Dance Academy's tuition and school policies. I am responsible for the full tuition for the class(es) for which I am registering and understand that tuition is non-refundable and payable in advance.I am aware, as with any physical activity, that dance can be a risk ?or personal injury. I expressly assume such risk and waive any and all claims or causes of action against West Hawaii Dance Academy, Theatre, Dance Centre, its Instructors and Contractors, owners of B & K Commercial Park, and Yumi Hancock arising out of or connected with my or my child s participation in classes and activities, including, but not limited to, claims from injuries.Signature of Parent or Guardian ___________________ Date _______ Witness ______________The signing of this form constitutes your contract for the full amount of fees. All fees are due prior to taking the first class. Missed classes must be made up within two weeks of absence.Registration Fee $10 ______ Paid(Date) ____________ Tuition paid _______________________74-5626	Alapa Street Bay 15 Kailua-Kona, HI 96740 Ph.(808) 329-8876 FAX (808) 329-1033 e-mail vh2dns4@ ilhawaii.net------------------------------------------------------------------