SUMMER INTENSIVE | Regen Trainee Program

Dancer's First Name

Dancer's Last Name

Dancer's Age as of 7/27/26

Contact Email

Contact Phone

Intensive Fees

6 DAYS (MANDATORY FOR RTP)$900

1 DAY - 5 CLASSES$160

1 CLASS (AGES 8 - HIGH SCHOOL SENIORS RATE)$40

1 CLASS (COLLEGE RATE)$25

1 CLASS (PROFESSIONAL RATE)$15

1 DAY & CLASS PASSES - PLEASE LIST DAYS AND CLASSES ATTENDING WITH TIME OF CLASS, LEVEL AND INSTRUCTOR

PHOTO/VIDEO RELEASE

I, as the parent or legal guardian, grant Regeneration, Regen Trainee Program and The Refinery my permission to use the photographs and videos described as photos and video footage of dancers from Regen Trainee Program and The Refinery for any legal use, including but not limited to: publicity, copyright purposes, advertising, and web content. Furthermore, I understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

Legal Guardian Signature OR Dancer's Signature (18+)

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Legal Guardian Name OR Dancer's Name (18+)

INJURY WAIVER

I, as the parent or legal guardian, acknowledge that participation in Regeneration, Regen Trainee Program and The Refinery classes expose you to a possibility of personal injury. I, being fully aware that participation in the program exposes you to possible risk of personal injury, hereby release Regeneration, Regenerative Beings, Regen Trainee Program, The Refinery and Director, Brian Stevens, from any and all liability from personal injuries.

I acknowledge that I have read and fully understand the Injury Waiver. This agreement shall be binding on myself, my spouse, my children and legal representatives.

Legal Guardian Signature OR Dancer's Signature (18+)

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Legal Guardian Name OR Dancer's Name (18+)