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I understand there is a non-refundable $50 deposit due at the time of registration and that all fees processed are non-refundable.

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I grant to Prisma Dance LLC, its instructors, staff or volunteers, all rights and permission to make, reuse, and/or publish photographic pictures and videos of myself and/or the participant(s), which may be used in connection with his or her own name or a fictitious name, for teaching and promotion purposes including the use of any printed matter and digital media. I waive any right to inspect or approve either the finished photograph or video, or the printed matter with which it may be used in conjunction. I certify that any photographs and/or videos that have been or will be taken by Prisma Dance, its instructors, staff or volunteers may be used for the purposes stated above.

The undersigned/participant hereby releases and forever discharges and holds harmless Prisma Dance LLC from any liability, loss, cost, and expense (including, without limitation, attorneys’ fees and costs) arising from or connected with the use of visual security cameras.

Upon registering for a trial lesson and/or continuing your participation in Prisma Dance, you are confirming your acknowledgement of the presence of the visual security cameras on site, which will be used as a tool for the purposes of safety, supervision, and documentation.

Upon signing this form, you acknowledge that you will also inform other family members, or authorized person(s) who pick up your child, about the visual security cameras at Prisma Dance.

The undersigned/participant understands that visual security footage is stored for a limited period of time. The undersigned/participant agrees to notify Prisma Dance office via email or phone call (prismadance@gmail.com or 808-224-9462) within 48 hours of any incidents of concern that may have occurred on Prisma Dance property.

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For and in consideration of being allowed to participate in any way in Prisma Dance LLC activities and events, the undersigned/participant:

1. Agrees that prior to participating, the undersigned/participant will inspect the facilities and equipment to be used, and will review the current cleaning procedures and any health and safety practices implemented, and if the undersigned/participant believes anything is unsafe, the undersigned/participant will immediately advise the instructor or supervisor of such condition(s) and may refuse to participate.

2. Acknowledges and fully understands that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own action, inaction or negligence, but the action of, inaction, or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not necessarily foreseeable at this time.

3. Understands this is a physical activity and assumes all the foregoing risks of participation and accepts personal and financial responsibility for any damages following such injury, permanent disability, or death.

5. Releases, waives, discharges, absolves and covenants not to sue Prisma Dance LLC, its respective administrator, instructors, staff and other volunteers of the organization, other participants, sponsoring agencies, and if applicable, owners and lessors of premises used to conduct the event, all of which are hereinafter referred to as "releasees" from demands, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasees or otherwise.

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In the event reasonable attempts to contact the designated emergency contact person and/or parent/guardian have been unsuccessful, I hereby give my consent for (1) the administration of any treatment deemed necessary by above-named doctor, or, in the event the designated preferred practitioner is not available, by another licensed physician or dentist; and (2) the transfer of the participant to any hospital reasonably accessible. This authorization does not cover major surgery unless the medical opinions of two other licensed physicians or dentists, concurring in the necessity for such surgery, are obtained prior to the performance of such surgery. I agree to assume all financial responsibility for all expenses from any and all medical care. It is understood that this authorization shall remain effective until I complete my activities in this program unless sooner revoked in writing.

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Illness: If a student becomes ill during class or during any Prisma-related event, the parent/guardian will be called and requested to pick up the student as soon as possible. For the wellness of all students and staff, parents are requested to keep sick children at home. A child who has had a fever or vomiting must be symptom free for 24 hours before returning to classes. Contagious Conditions: If a student has a contagious condition, please notify the school immediately. Children with a contagious condition must stay home from school until the condition has been resolved or remedied, at least 24 hours free from condition. Common communicable diseases include, but are not limited to: common cold with fever, strep throat, ringworm, pinkeye, staph infections, scabies, hepatitis, mononucleosis, measles, mumps, HFM, chickenpox and whooping cough. Lice: Students with an active case of lice are asked to refrain from coming to classes. Prisma requests that the child's condition be treated with medicated shampoo and/or lotion prior to returning to class. Bathroom Assistance: Parents are responsible to assist their child to use the bathroom if their child needs assistance. Parents grant permission to Prisma Dance and its instructors, staff, and/or volunteers to assist their child to use the bathroom if the parent is not present.