Student Information

Please fill out the following form.

Parent/Guardian

Billing Authorization

I represent and warrant that if I am purchasing something or paying for a service from this facility or from other merchants through this facility that (i) any credit card or bank account draft (ACH Draft) information I supply is true and complete, (ii) charges incurred by me will be honored by my credit card company or financial institution, and (iii) I will pay the charges incurred by me at the posted prices, including any applicable taxes, fees, and penalties.

I hereby authorize (if online payment is made or autopay information is provided) this facility to charge my ACH draft, or credit card account.  I am responsible for payment whether or not my student attends classes until the end of the current session.

Waiver

I, the undersigned participant, or the legal guardian of the participant if under 18 years old, hereby acknowledge and agree to the following terms and conditions:

1. Assumption of Risk: I understand that participating in dance classes or activities involves certain risks, including but not limited to physical exertion, contact with other participants, and the risk of injury. I voluntarily assume all such risks associated with participating in dance classes or activities.

2. Physical Condition: I certify that I and/or my child is physically fit and have/has no medical conditions that would prevent me/him/her/they from participating in the studio’s dance classes or activities. I understand that it is my responsibility to consult with a physician prior to participation if I have any concerns regarding my or my child’s physical condition.

3. Release of Liability: In consideration of being allowed to participate in dance classes or activities at Dancing Arts studio, LLC, I hereby release, discharge, and hold harmless Dancing Arts studio, LLC, its owners, instructors, employees, and representatives from any and all claims, liabilities, demands, actions, or rights of action that may arise out of or be related to any loss, damage, or injury, including death, that may be sustained by me or to any property belonging to me, whether caused by the negligence of Dancing Arts studio, LLC or otherwise.

4. Indemnification: I agree to indemnify and hold harmless Dancing Arts studio, LLC, its owners, instructors, employees, and representatives from any loss, liability, damage, or cost they may incur due to my participation in dance classes or activities at Dancing Arts studio, LLC.

5. Consent to Medical Treatment: In the event of an emergency, I authorize Dancing Arts Studio, LLC and its representatives to secure medical treatment for me and/or my child if deemed necessary. I understand that I will be responsible for any medical expenses incurred as a result.

6. Media Release: I grant Dancing Arts studio, LLC the right to use photographs, videos, or other media taken during dance classes or activities for promotional purposes, including but not limited to websites, social media, and printed materials.

7. Governing Law: This waiver and release of liability shall be governed by and interpreted in accordance with the laws of the State of Connecticut.

I have read this dance studio waiver and release of liability, fully understand its terms, and agree to be bound by them. I acknowledge that I am signing this document voluntarily and without any inducement or assurance of any nature.