Personal DetailsPlease fill out the form below prior to your first class. All details are confidential ♡ Student Name * First Name Last Name DOB * MM DD YYYY Email * Phone * (###) ### #### Address * Emergency contact * First Name Last Name Emergency contact number * (###) ### #### Medical Do you have any medical conditions or injuries? * No Yes If yes, please give more details. Disclaimer * I understand that there is a risk of injury associated with participating at Stellar Aerial Arts. I hereby assume full responsibility for any and all injuries, losses and damages that I may incur while attending, exercising or participating at Stellar. I agree Signed * Or Parent/Guardian signature if student is under 18. First Name Last Name Date * MM DD YYYY Thank you!