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AfroFusion Flow Registration Form
Full Name
Email
Phone
Date of Birth
Street Address
City / State / ZIP
Participant is:
Adult
Teen
Parent/Guardian Name, if participant is under 18:
Name
Relationship
Email
Experience Level
Beginner
Some experience
Experienced dancer
Primary Interest
Fitness
Culture
Community
Dance training
Fun / stress relief
Please share anything the instructor should know so the class can be safe and welcoming. Write N/A if none. Medical conditions, injuries, or mobility considerations:
Accessibility needs or accommodations requested
Allergies or other concerns
Agreement
I understand this is a physical movement class and I will participate at a level that is safe for me.
Sankofa Travels With Kofi may take photos or videos for promotional, educational, or archival purposes. Please select one:
I grant permission to use photos/videos of me or my child.
I do not grant permission to use photos/videos of me or my child
Agreement
By signing below, I acknowledge that dance and fitness activities involve physical movement and some risk of injury. I agree to follow instructor guidance, participate responsibly, and notify the instructor of any limitations. I release Sankofa Travels With Kofi, its instructors, volunteers, and partners from liability for injuries or losses except where prohibited by law.
By signing below, I acknowledge that dance and fitness activities involve physical movement and some risk of injury. I agree to follow instructor guidance, participate responsibly, and notify the instructor of any limitations. I release Sankofa Travels With Kofi, its instructors, volunteers, and partners from liability for injuries or losses except where prohibited by law.
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