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As with all exercise, dance and movement programs, when using our instruction, in person or online, you need to use common sense and perform them at your own risk. You recognize and acknowledge there are certain risks and physical injury and you agree to assume full risk of any injuries, including damages, death or loss which may be sustained as a result or participation in any activities connected with Kinetics Academy of Dance. In case of illness or accidents, I consent to emergency medical care for my child/myself to be provided by ambulance or hospital personnel. I acknowledge the contagious nature of COVID-19 and other contagious diseases and viruses and voluntarily assume the risk that I and/or my children may be exposed to or infected by COVID-19 or other contagious diseases and viruses by attending and/or participating.

The undersigned acknowledges receipt of above tuition policies, accepts financial responsibility for student as named and authorizes Kinetics Academy of Dance to have the fees related to the account charged to signer's credit card as indicated below. Permission is also given to use the student's image, still or video, in Kinetics materials.

Kinetics Academy of Dance, it's instructors or the owners of this facility may not be held liable for any injury, accident or illness sustained as a result of participation in this program, in person or through distant learning and practicing including, not limited to, Facebook, Instagram, Band, Twitter, Zoom, YouTube, Dropbox or Google Drive.

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IMPORTANT INFORMATION REGARDING CONCUSSIONS. On January 1, 2012. AB 25, a new law on youth sports concussions took effect in California. If a player is suspected of sustaining a concussion or head injury during a game, the player shall be immediately removed from the game. Once a supervising employee determines that a player should be removed from a game based on a suspected or potential concussion or head injury, no other coach, parent or involved individual may overrule this determination. Players who have been removed from an activity because of a suspected or potential concussion or head injury, will not be allowed to resume any participation in the activity until he/she has been evaluated by a licensed health care provider and has received full medical clearance to resume participation. Signing this Agreement Form shall be considered a waiver of any claim for such injury or loss. Signing this Agreement Form authorizes Kinetics Academy of Dance to obtain medical treatment and services for the student when the parent(s) or legal guardian(s) are not present, and the parent(s) or legal guardian(s) agree to pay the fees and costs of such medical treatment and services. Signing this Agreement Form acknowledges that the player/parent(s) have received access to information concerning concussions and understands that if there is a question of a concussion, AB25 will be implemented.

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Cancellation must be received before noon the Thursday prior.

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I authorize Kinetics to charge my card on file for all fee for this event unless I make payment via another method .