Registration Form | Northwest Hula Com 1

First name

Last name

Address

Phone

Birthday

Month

Day

Year

Emergency Contact. Name, Phone Number, Relationship

Class Type

Beginners

Advanced Wahine

Juniors (ages 10-16)

Keiki (ages 3-9)

How did you hear about us?

Any prior hula dance instruction?

Any existing health conditions or currently taking any medications?

Media Use

I DO NOT consent to pictures taken at events to be used on NW Hula social media or website

I do consent to pictures taken at events to be used on NW Hula social media or website

By participating in any Northwest Hula Company LLC class, event, or activity, I acknowledge that hula involves physical movement and risk of injury. I voluntarily assume all risks & release Northwest Hula Company LLC and its instructors from any liability

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