PARTICIPANT INFORMATION


MaleFemale



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MEDICAL AUTHORIZATION

You have our permission, in the event of an emergency and in case we are unavailable, to authorize any physician, nurse practitioner or medical personnel to examine, interview, test and if necessary, treat my child as they may deem advisable.

PARENT STATEMENT

I hereby state that (student’s name) is in good mental and physical health condition to participate in the activities provided by SCORE, including but not limited to all aspects of dance, training, yoga, and or competition.

I understand that SCORE has the right to deny admittance to any student not meeting the standards of the program as it sees fit. I also agree not to hold these parties responsible in the event that my son/daughter/child engages in inappropriate conduct (including, but not limited to disruptive or volatile behavior in or out of the center’s premises, etc.) or becomes involved in any activity or with any persons not associated with SCORE, or its scheduled program and that SCORE, has the right to send him/her home for inappropriate conduct. I further attest that the information contained in this application is correct to the best of my knowledge. In addition, I have agreed to the policy and fee statement and agree to comply.

I agree to let Scorehub use photos taken at the center.
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