• Fall 2026 Master Class - School of Dance Online Form

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  • Student's Birthdate
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  • PARTY RESPONSIBLE FOR PAYMENT IF STUDENT IS UNDER 18 YEARS OF AGE

  • Please make your choice of class(es) below:
  • FEES ARE NON-REFUNDABLE

  • Cost is $25

     

     

  • Photo Release

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  • Payment Options

  • NOTE: After payment is submitted, please return to this page to submit the registration form.

    When using PayPal please include dancer's name in the Notes section.

    To pay via Credit/Debit or PayPal please use the following link or scan the QR Code.

    http://www.upike.edu/school-of-dance

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  • Please choose which option you will be paying by:
  • Liability Release Section

  • Please read carefully and sign the statement below

    Release of Liability: The participation in certain events and classes such as swimming, martial arts, dancing, aerobics, hiking, whitewater rafting is inherently dangerous and involves the risk of injury to the participant. University of Pikeville, a non- profit institution, can only provide teaching service and facilities for classes upon the expressed agreement that each individual participating is at his/her own risk.

    By signing this agreement, the student/parent/guardian accepts all risks involved in these activities and further releases the University of Pikeville, its instructors and personnel, from any and all loss, damage or any claim or demand therefore because of any injury to the student/parent/guardian, personal property, or death of the student/parent/guardian, whether caused by negligence of the University, its instructors or personnel, or otherwise while the student/parent/guardian is on or upon the facilities of the University, or traveling to or therefrom, and/or competing, participating, officiating in, observing, working for, or for other purposes participating in University sponsored activities.

    The undersigned student/parent/guardian recognizes that his or her (or child’s) participation is completely voluntary and the STUDENT/PARENT/GUARDIAN ACCEPTS ALL RISKS

    AND RESPONSIBILITY FOR PARTICIPATION THEREIN. THE UNDERSIGNED STUDENT/PARENT/GUARDIAN AGREES TO INDEMNIFY THE UNIVERSITY OF PIKEVILLE FOR ANY LOSS SUSTAINED BY THE UNIVERSITY, ITS INSTRUCTORS OR PERSONNEL, DUE TO PAYMENT OF DAMAGES OR OTHER COMPENSATION FOR INJURY OR LOSS.

    By signing below, the undersigned states that he/she has read the foregoing and agrees to the limitation of liability contained therein.

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