Class Registration Form

Don't want to use a Credit Card? No problem.  We prefer Cash or Check. Use this form to register and let us know the form of payment in the drop-down box. 

Parent Name (if student is a minor) *
Parent Name (if student is a minor)
Phone *
Student Name *
Student Name
Summer Intensives
If you selected "None of These" or "Play in a Day: No School Day Camps" please specify which class or date you are registering for. Play in A Day Dates: SEPTEMBER 21st: K-8th Grade/OCTOBER 19th: K-8th Grade/NOVEMBER 12th: K-5th Grade/MARCH 4th: K-5th Grade/APRIL 12th: K-8th Grade/MAY 17th: K-5th GRADE
Photo Release *
I hereby give La-De-Da Performing Arts the permission to use my or my child’s photograph publicly to promote the La-De-Da Performing Arts. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. I agree to allow my student to be in photos.
Please provide any medical information of which we should be aware of including allergies and medical conditions.
Emergency Contact Name
Emergency Contact Name
Or secondary contract information for a parent or legal gaurdian.
Emergency Contact Number
Emergency Contact Number
Physician Name *
Physician Name
Physician Number *
Physician Number
Liability Waiver *
Liability Waiver
I allow my student to participate in classes at La-De-Da Performing Arts and do hereby release, forever discharge and agree to hold harmless La-De-Da Performing Arts, its owners, directors, employees, volunteers and teachers from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the student while involved in the children/youth/adult classes. Furthermore, I, on behalf of my minor student, hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreation activities involved therein.
Date *
How do you plan to make registrations payment?
If you are signing up more than one student please specify that here.