Dancer's Full Name *

First Name

Last Name

Parent/Guardian Full Name *

First Name

Last Name

Billing Address *

Payment will be accepted via e-transfer, and a full billing address will be required for our records. Thank you for your understanding!

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

Country

(###)

###

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Agreement to Terms and Conditions: *

This section acts as a waiver of liability and confirmation of acceptance of event terms. Please read carefully and check each box to confirm your understanding and agreement:

Assumption of Risk: I understand and accept all risks associated with participating in this event, including risks caused by the negligence of VERTEX VIBE and its representatives.

Responsibility for Injury or Loss: I accept full responsibility for any injury, loss, or damage that may occur during my participation, even if caused by the negligence of VERTEX VIBE.

Release of Liability: I release VERTEX VIBE, its directors, instructors, and affiliates from any claims, demands, losses, or medical expenses arising from my participation.

Hold Harmless Agreement: I agree to indemnify and hold harmless VERTEX VIBE and its representatives from all liability, expenses, or claims, including those caused by negligence.

Photo & Video Consent: I give permission to VERTEX VIBE to use my (or my child’s) photographs, videos, or likeness for promotional, advertising, and commercial purposes without compensation.

Privacy Protection: I understand that images will not include full names or personal identifying information without prior consent.

I agree to all the above terms and conditions.

Digital Signature *

Please type your full name as your digital signature to confirm the above agreement(s).

First Name

Last Name

Check the boxes below to confirm you're registering for the Halifax event. *

You are confirming attendance for the following event: Intermediate Level: Wednesday, July 9th, 2025 (NEW ADDITION) Location: House of Eights Dance Studio 5562 Sackville St, 3rd Floor (Suite 305, Halifax, NS B3J 1L1) Level: Intermediate (Ages 9-12) @ $210+HST Date: Thursday, July 10th, 2025 Location: House of Eights Dance Studio 5562 Sackville St, 3rd Floor (Suite 305, Halifax, NS B3J 1L1) Level: Advanced (Ages 13+) @ $225+HST

I understand that I am registering my dancer for the level that best suits their needs.

I acknowledge that their spot will be secured only after the payment is made via e-transfer to info@vertexvibe.com and a final receipt is received.