Registration

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Our Early Bird Program is designed to instill the love of dance through technique development, musical exercises, teamwork and play. Ages 4-7. Classes will be held Monday - Friday. Classes begin at 9am with an option to drop-off at 8:30am. Pick up is at 4:00pm. Parent(s)/Guardian(s) are to provide lunch, snacks and refillable water bottles each day. The program takes place July 22nd - August 3rd, 2024; Demonstration on August 3rd. Tuition is $1050 with a nonrefundable $150 deposit and $25 registration fee. Each family receives 2 tickets to the Demonstration on August 3rd. All funds are due by July 16. No refunds after July 8th, 2024.

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Start Date/Time:

End Date/Time:

Fee per Student:

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* - denotes required fields

Family Information

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

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info (Not Contact #1 or #2)*

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:*
	Allergies:
	Medications:
	Primary Doctor:*
	How do you Identify Ethnically:

Questions/Options:


I agree that DADA can charge my credit card for the $150 non-refundable fee plus the $25 Registration fee*
I agree that DADA can charge my credit card for the $1050 tuition fee plus $25 Registration Fee*
Please choose your child's T-shirt size. All sizes are Youth - Small, Medium, Large or X-Large*
Charge Card for a LAPA (Required for African) $20

Additional Information:

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WHEREAS, The Debbie Allen Dance Academy and Debbie Allen Dance Inc., and its directors, officers, employees, agents, licensees, successors, assembles, and/or any third parties designated by the Debbie Dance Academy, separately and jointly hereafter referred to as DADA.

I/We (individually or jointly), as parent (s)/legal guardian(s) of the above-named student, agrees to the following:

General Authorization

1. That I/We have enrolled the above-named student at DADA for dance training and that it is understood that from time to time it will be necessary for DADA to arrange for the services of independent contractors to manage and operate DADA as a dance training and instruction institute, and do hereby at all times hold harmless, discharge and release DADA from any and all liability for injury, loss, damage, obligation, expense, or penalty sustained by the above-named student arising out of or in connection with the above-named student’s participation at DADA;

2. That I/We acknowledge that the above-named student will be physically touched from time to time during his/her dance training and instruction and will not hold DADA liable for such physical touching;

3. That I/We authorize DADA to photograph, film, videotape, record or otherwise capture in any media the above-named student’s dance training, instruction, and performances and to use such recordings for instruction, promotion, publicity and broadcast uses. All ownership and copyright, title and interest in these recordings shall belong to DADA. I/We further grant DADA the right to use the above-named student’s name and bio, portrait, picture, likeness and recordings thereof for the purposes of advertising, publicizing, and promoting DADA;

4. That I/We authorize DADA or DADA's physician or nurse, if any, to provide or authorize medical care for the above-named student as needed or requested. In cases of emergency, DADA is authorized to arrange for medical services and consent to appropriate medical and surgical service recommended by licensed medical professionals. I/We accept full responsibility for all costs of the medical care and any emergency treatments. DADA will not be responsible for the payments for any medical care or emergency treatments, but will accept billing in its name only to facilitate submission of medical insurance claims for the above-named student, if applicable, or for the prompt forwarding of bills to me/us;

5. That I/We agree that DADA will not be liable for authorizing medical treatments for the above-named student pursuant to my/our authorization in paragraph 4 above and waive all claims whatsoever in connection with such medical treatments. I/We agree that DADA will not be liable for and agree to hold DADA harmless from any liabilities, losses, injuries, damages or expenses related to the above-named student's participation in any of the activities at DADA and from the Student's enrollment at DADA generally. Any and all claims against DADA are waived. Any damage and harm by the above-named student will be the responsibility of the parent/legal guardian;

6. That I/We authorize the above-named student to participate in any DADA sponsored or related activities or excursions, whether held on DADA grounds or otherwise, including swimming, recreational, educational, and cultural activities. In arranging for such activities or excursions with third parties I/We acknowledge and agree that DADA is acting as the agent for the student;

7. That I/We agree, if DADA incurs legal fees and expenses in connection with the enforcement of this Summer Intensive - 2024 Contract to pay or reimburse DADA for all such reasonable costs within thirty (30) days after receiving written notice of such charges;