Indicates required field
Parent's Name (if applicable)
Email (Gmail Preferred)
Kids Class Selection
Sat 10am (10-11)
Sat 11am (11-12)
Tues 6pm (12-15)
Mon 6pm (13-17)
Wed 6pm (12-17)
Thurs 6:30pm (15-17)
Adult Class Selection
Monday 7:00-8:00pm (Beginner Hip Hop)
Tuesday 7:00-8:00pm (Beginner Hip Hop)
Tuesday 8:00-9:00 (Beginner Hip Hop)
Wednesday 7:00-8:00pm (Beginner Hip Hop)
Wednesday 8:00-9:00pm (Intermediate Hip Hop)
Thursday 8:30-9:30pm (Intermediate Hip Hop)
How Did You Hear About Us?
Social Media (Twitter/Instagram)
If Friend Referral, List friend:
I understand that dancing is a physical activity that may result in physical injury and I will not hold Nickelz Production liable for any extent of an injury that may result from participating in a Nickelz Production Dance Class. I understand that I should be aware of my physical limitation and agree not to exceed them. If I am signing this waiver for my child, I certify that I am the parent or legal guardian and have the right to waive these rights on behalf of the dance student named above.
Yes, I grant permission for Nickelz Production to use photography and video taken during class or Nickelz Production sponsored events for publicity purposes of the student name above
Reuse of Choreography
I understand that the video of the choreography sent to me after class is only intended for personal use and cannot be reproduced or taught again in a professional manner without the consent of the original choreographer.
Nickelz Production Dance Studio
Copyright © 2020 Nickelz Production LLC. All rights reserved.