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Registration
To register, please take the time to fill out the information below.
Student's First Name
Student's Last Name
Email
Mobile Phone
Birthday
*
required
Address
City
Zip Code
Check if you have a partner.
Partner's First Name
Partner's Last Name
Partner's Email
Partner's Mobile
Partner's Birthday
Partner's Address
City
Zip Code
What type of dancing are you interested in learning? (select all tha apply)
*
Required
Latin
Ballroom
Swing
Country
Folklorico
Wedding Choreography
QuinceaƱera Choreography
Have you had prior dance instruction? Please explain.
Where will you be using your dance?
What type of music do you like? (select all that apply)
*
Required
Top 40
Latin
Big Band
Rock
House Techno
Country
Swing
R&B
Hip Hop
Other
Why did you decide to start taking dance lessons?
Liability Waiver: I understand that my participation in the dance classes offered by Cortez Ballroom may result in injury. I acknowledge that certain types of injuries are common among dance-related classes/events and that I am assuming the risk of such injury by participating in dance classes with Cortez Ballroom. In the event of injury, I authorize Cortez Ballroom to obtain necessary medical treatment on my behalf. I understand that Cortez Ballroom, the host venue, Izabel Cortez, employees, teachers, assistants, staff, crew, or other guests are not liable for personal illness, injury, damage, or loss to personal property. I understand that I will be responsible for any and all medical and related bills that may incur for any illness or injury that I may sustain in classes or events. I also understand I may be declined to participate in any class or activity.
*
Required
I accept terms and conditions
I do not accept terms and conditions
Liability Waiver: I understand that my participation in the dance classes offered by Cortez Ballroom may result in injury. I acknowledge that certain types of injuries are common among dance-related classes/events and that I am assuming the risk of such injury by participating in dance classes with Cortez Ballroom. In the event of injury, I authorize Cortez Ballroom to obtain necessary medical treatment on my behalf. I understand that Cortez Ballroom, the host venue, Izabel Cortez, employees, teachers, assistants, staff, crew, or other guests are not liable for personal illness, injury, damage, or loss to personal property. I understand that I will be responsible for any and all medical and related bills that may incur for any illness or injury that I may sustain in classes or events. I also understand I may be declined to participate in any class or activity. Appearance Agreement: I understand that as a participant in and or a spectator of dance with Cortez Ballroom. I may be included in videotapes or photographs taken during the classes or events. I agree to be advertising and promoting events for Cortez Ballroom and Danz with Izabel. ā *By signing this document, I have read and understood, rules and regulations for dancing with Cortez Ballroom.
*
Required
I accept terms and conditions
I do not accept terms and conditions
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