SUSPENDED FORM

Name

Date of birth?

Email

Phone Number

Mailing Address

Have you taken an ASA! class before?

yes no

CPR/AED certification and expiration date

Dance experience

Fitness Experience

How did you find out about the ASA! certification?

List and describe any injuries or ailments you’ve had in the past 3 years

Why have you chosen to audition?

Digital signature

Clear

Terms of Service

Applicant hereby stipulates that he/she is physically sound and that he/she has approval to proceed with a routine of exercise. LIMITATIONS OF EXERCISE, IF ANY: It is further expressly agreed that all strength training, cardiovascular exercise, or any other exercise shall be undertaken by me at my sole risk and that ASA! Enterprises LLC and representatives or employees shall not be liable to me for claims, demands, injuries, damages, actions or causes of action, whatsoever, to my person or property arising out of or connected with the use by me of the services provided and of the premises where the same is located. I do hereby expressly forever release and discharge ASA! Enterprises LLC and representatives or employees from all such claims, demands, injuries, damages, actions or causes of action, from all acts of active or passive negligence on the part of ASA! Enterpirses LLC and representatives or employees.