Student Name
*
First Name
Last Name
Student Birth Date
*
MM
DD
YYYY
Please select the location you are registering for.
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450 Enterprise Ct. Bloomfield Hills, MI 48302
Detroit Country Day School
Please select the session you are registering for.
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Fall 24/25
Once Upon A Dream Dance Class
Gender
*
Female
Male
Non-Binary
Prefer to self describe
Ethnicity
*
Parent Email
*
Parent Cell Phone Number for SMS Communication
*
You can opt out of receiving SMS communications by getting in contact with the school director or school business manager.
(###)
###
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Home Phone
(###)
###
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Billing Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Mailing Address
Please fill this out if your billing address is different from your mailing address.
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Parent or Guardian #1
*
First Name
Last Name
Parent or Guardian #1 Occupation & Employer
*
Parent or Guardian #2
First Name
Last Name
Parent or Guardian #2 Occupation & Employer
Emergency Contact
*
First Name
Last Name
Emergency Contact Relationship
*
Emergency Contact Phone Number
*
(###)
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Please list each Class, Day and Time you would like to register for.
*
Leotard Size (ex. Youth Small - 6/7)
Would you like to sponsor an Eisenhower Dance Detroit company dancer? ($2,000 donation required)
*
Yes
No
Maybe - please send me more information
Would you like to sponsor an EDD Youth Ensemble company? ($1,000 donation required)
*
Yes
No
Maybe - please send me more information
How did you hear about EDD?
*
Google Ad
Facebook
Instagram
Print Ad
EDD Performance
Word of Mouth
Other
By typing my name, I am agreeing to the liability terms listed below
*
I understand and agree that in participating in any dance class, workshop, rehearsal or performance,
there is a possibility of physical injury or death. I voluntarily agree, therefore, to assume all risks and
responsibility for any such injury or accident, which might occur to me or my child during any of the
School of Eisenhower Dance Detroit classes, rehearsals, performances, or activities. I also exempt,
release, and indemnify Eisenhower Dance Detroit, its owners, agents, volunteers, assistants, employees,
guest artists, faculty members, and/or students from any and all liability claims, demands, or causes of
action whatsoever from any damage, loss, injury, or death to me, my children, or property which may
arise out of or in connection with participation in any classes or activities conducted by the school of
Eisenhower Dance Detroit. I further hereby voluntarily agree to waive my rights and that of my heirs
and assigns to hold Eisenhower Dance Detroit, its owners, agents, volunteers, assistants, employees,
guest artists, faculty members, and/or students liable for such damage, loss, injury, or death. I
understand that I should be aware of my physical limitations and agree not to exceed them. If I am
signing this waiver for my children, I certify that I am the parent or legal guardian and have the right to
waive these rights.
By typing my name, I am agreeing I have read, understood and accept the EDD Billing and Class Policies
*
