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Theme: Hawaiian w/Moana

Does your child love to twirl, play make believe and dress-up? Then they will LOVE becoming a Princess Ballerina! (Children 4-7yrs)

3 Hours of MAGICAL FUN!! We will start with some fun games as we get settled in. Dance instruction will be presented in a fun and engaging way by our talented and energetic dance instructors. Your child will have a wonderful time learning a fun dance, doing crafts and have snacks and tea with a real Disney princess!!

**Limited Spots - only $35**

CHECK-IN: Starts at 8:45am, but please pre-register!

Event:

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Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info

Students entered below will be added to your family's account

Add New Student #1:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
	Student Email:
	School:	Grade Level:
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):
	Primary Doctor:

Questions/Options:


1. Parent or Guardian's name?*
2. Does your child have any special physical/mental conditions that we need to be aware of or might make it difficult to do the activities that are common to dance classes? (running, spinning etc)
3. Does your child(ren) have any special food conditions that we need to consider? (No nut items will be served)
4. Is there any scheduling conflicts that we need to know about? (Come late, leave early or skip activities)
5. Is this your FIRST time coming to one of our Camps?
6. How did you HEAR about our Camps? (Email, Facebook, friend, etc)

Additional Information:

PARENT RELEASE FORM

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DROP-OFF

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SNACKS

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ATTIRE

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INSIDE ACTIVITIES

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PICK-UP

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CORRESPONDENCE

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MARKETING RELEASE

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ASSUMPTION OF RISK

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I am fully informed of the "normal" inherent risks associated with trampolines, foam pits, rock climbing walls, and inflatable equipment, and it is my desire to participate in the Star Studio's Dance, Tumbling, Parkour, Trampoline or any other sanctioned class Instruction, Competition Program, Open Gym, and Birthday Party/Facility Rental. With the consideration of participating in this activity, I hereby knowingly and intelligently assume the risks of harm and/or body injury to my person or property that are associated with or arise out of this activity.
A) Participants may suffer cuts, scrapes, bumps, bruises, the transmission of disease strains and allergic reactions through use of the Star Studio facility equipment or contact with other participants or surfaces they have contacted. Participants may sprain, pull, break or otherwise seriously externally or internally injure their head, face (including nose and teeth/jaw), neck, torso, spine, arms, wrists, hands, legs, ankles, feet or other body parts as a result of falling off the trampoline(s) or other equipment, landing improperly on the trampolines or other equipment, or making contact with other participants.
B) As noted above, such injuries can lead to paralysis, disfigurement or death. Participation may result in heat stroke, heart attacks, dehydration and other exertion-related medical events.
C) Participants may fall on each other, resulting in broken bones and other serious injuries. Double bouncing, more than one person per trampoline, flipping, running and bouncing off of the walls and wall-mounted trampolines, and other participant body movements (whether planned or unplanned) can create a rebound effect and lead to unpredictable body movements and anticipated or unanticipated bodily contact, any or all of which can lead to serious injury.
D) Traveling to and from trampolines can result in similar physical injury (even if the participant is not himself or herself bouncing at the time).
E) Observing, standing, sitting or taking photographs at or near any trampoline or activity can result in similar physical injury (even if the observer is not himself or herself participating at the time).
F) Participation during reduced, altered lighting or blacklight events can affect depth perception and visibility and may cause me and/or my Child to fall, slip, misstep, collide with other jumpers, or collide with equipment which can result in a greater risk of serious physical or emotional injury, paralysis, or death.
H) Trampolines, foam pits, rock climbing walls, inflatable equipment and any other surface or activity found at Star Studio require a certain level of skill to use properly. I am solely responsible for allowing my child to interact with such said activities and equipment understanding their inherent risks.
I) My negligence or the negligence of others may cause these risks and dangers. There may be other risks not known or reasonably foreseeable at this time.

I've read the above and agree.

RELEASE OF LIABILITY

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As the legal parent or guardian, I release and hold harmless Star Studio, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Star Studio, its owners and operators or in route to or from any of said premises.

By signing below, I represent and warrant that I am the parent, legal guardian, or power-of-attorney of the above listed Child(ren) and have the authority to execute this Agreement on his/her or their behalf and to act on his/her or their behalf. I have had sufficient time to read each and every paragraph in this document and I and they agree to be bound by the terms stated therein, including the release of liability contained therein. I understand that employees working at Star Studio, including the manager, do not have the authority to waive any provision of this Agreement. This Agreement constitutes and contains the entire agreement between Star Studio and me relating to the Child’s and my use of the Star Studio facility. There are no other agreements, oral, written, or implied, with respect to such matters. I agree that if any portion of this Agreement is found to be unenforceable, the remaining portions shall remain in full force.

I further agree to indemnify and hold harmless the Releasees from any and all claims which are brought by or on behalf of this or these minor Child or Children, or any of them, which are in any way connected with, arise out of, or result from their use of the Star Studio facility. I am 18 years of age or older. I am entering this agreement on behalf of myself, my spouse or domestic partner, the Child, and our respective and/or collective issue, parents, siblings, heirs, assigns, personal representatives, estate(s), and anyone else who can claim by or through such person or persons (collectively, the “Releasing Parties”). This Release Form covers all interactions with Star Studio. It includes, but is not limited to: Class instruction, Performances, Competitions, Open Gym, Party Rentals, etc. whether on or off Star Studio property. This Release Form is considered valid and binding until notified otherwise.

IN SUMMARY, BY MY SIGNATURE BELOW, I ACKNOWLEDGE THAT IF I OR ANY OF MY CHILDREN ARE INJURED IN ANY WAY, THIS WAIVER PREVENTS AND PROHIBITS ANY RECOVERY OF MONEY FROM ANY STAR STUDIO RELATED ENTITY.

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