CCF Day of Dance Ballroom Registration - Carole Cascio Fund for Mind Movement Dance Connections

Carole Cascio Fund’s Day of Dance at the Todd Performing Arts Center at
Chesapeake College

Ballroom Dance Class Registration Form

Carole Cascio Fund’s Day of Dance at the Todd Performing Arts Center at Chesapeake College

Dance Class Registration Form

Please complete the form below to register for any of the free Ballroom Dance Class during the Day of Dance on Saturday, November 4, 2023.

Ballroom Dance Class will be held from 10am-11am

at the Health Professions & Athletics Center Bldg – Yoga Studio Room 103

If you have any additional questions, please contact Peter Pucci at ppucci@carolecasciofund.org

First Name

Last Name

If you are affiliated with a school or studio, please note it here:

You must accept the terms below to submit your registration

I understand the risks of physical injury inherent in dance and dance training, and I fully assume those risks while participating in the Day of Dance. I agree to indemnify, defend, and hold harmless the Carole Cascio Fund and Chesapeake College, their sponsors, agents, employees, and their representatives from and against all claims, damages, suits, liabilities, losses, and expenses arising or resulting from any injury or loss of personal property. This includes claims for negligence.

Media Release

I authorize the Carole Cascio Fund and Chesapeake College, to use and publish photographs of me and/or my child in any media published by or under its authority.

Carole Cascio Fund’s Day of Dance at the Todd Performing Arts Center atChesapeake College Ballroom Dance Class Registration Form

Carole Cascio Fund’s Day of Dance at the Todd Performing Arts Center at Chesapeake College Dance Class Registration Form

Carole Cascio Fund’s Day of Dance at the Todd Performing Arts Center at
Chesapeake College

Ballroom Dance Class Registration Form

Carole Cascio Fund’s Day of Dance at the Todd Performing Arts Center at Chesapeake College

Dance Class Registration Form