Skip To Main Content
Wildcat Dance Off event logo

Dancer Registration


Student First Namerequired
Student Last Namerequired
Student Addressrequired
Zip Coderequired
Current School
Team Name
Parent/Guardian First Namerequired
Parent/Guardian Last Namerequired
Relationship To Studentrequired
Parent/Guardian Phone Numberrequired
Parent/Guardian Emailrequired
Emergency Contact Name
Emergency Contact Phone Number
Pertinent Medical History
Please list any food or environmental allergies your child may have.
Allergy MedicationDoes your child require medication for this allergy?
Does your child require medication for this allergy?
Allergy Medication
Please list the allergy medication.
Please list any medication(s) your child is currently taking and the reason for the medication.
Current health problems/concerns:
Special precautions
Are there special precautions you wish NFA staff to know concerning your child's medical history?

Parent/Guardian Acknowledgment: I certify that I am age 18 or older. I have carefully read and freely sign the Acknowledgment & Assumption of Risk, Release, and Waiver of Liability. I fully understand and agree that this Acknowledgment & Assumption of Risk, Release, and Waiver of Liability is a legally binding agreement, that I on behalf of myself and the Student have given up substantial rights by signing it, that no oral or written statements or representations can or will alter the contents of this document, and that I and Student sign it freely and voluntarily without any inducement or undue influence. I agree that this agreement shall be governed by the laws of the State of Connecticut (excluding its conflict of laws principles), which shall be the forum for any lawsuits filed under or incident to this agreement or the Sports Activities. I further agree that this agreement is intended to be as broad and inclusive as is permissible by the laws of the State of Connecticut and that if any portion of this agreement is held to be invalid, it is agreed that the balance shall, notwithstanding, continue in full force and effect.

NFA Public Relations/Student Names and Photos - Norwich Free Academy often uses images/photos of students on our website, social media, promotional materials and advertisements. If you do not want your child’s name and/or picture to appear in any NFA promotional materials, in print or digital form, please email with your child's name and the program they are attending.

*Norwich Free Academy may call 911 for transport to the nearest hospital in the event of an emergency.

My signature indicates: That I have read and agree to NFA's terms and conditions regarding the Acknowledgment & Assumption of Risk, Release, and Waiver of Liability, medical emergencies, and public relations and that the medical information which I have provided is accurate and complete.


Please type your name to sign this document.