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This is the perfect dance camp for dancers who want to be pushed in a wide variety of dance genres including tap, jazz, lyrical, and hip hop. You can choose to sign up for one day for $60 or participate in both days for $110. Dancers should bring water bottles with their names on them as well as dance shoes with names written in them. What to wear: Girls- Leotard and tights of any color, booty shorts and jazz or ballet shoes. Boys- t-shirt and shorts, dance shoes (or socks) Thursday, July 25th 5:30pm-8:30pm Ages 4+ $60 for one day

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Family Information

	First Name:*	Last Name: *
	Relationship to dancer*
	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):

Additional Information:

Parent/Student Waiver

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General Information
It is expected that all students will conform to the rules of the studio and behave in a manner courteous to staff and fellow students. Absolutely no one should be in dance rooms unless invited by the teacher. All families are expected to adhere to any updated health protocols. Teachers cannot easily talk with parents between classes. If you need to speak with a teacher, please send an email to Miss Kerri at info@impulsedanceacademy.org . She will get back to you promptly. Updated information about our dance studio is always available on our website www.impulsedanceacademy.org or our Facebook page @ImpulseDanceAcad
Note: Promptly notify us of any change of phone or address.

Parent
Due to Covid-19, we are not allowing any parents in the lobby area during camps EXCEPT for families attending the Teddy Bear Camp for 2-3 year olds. All other parents will be expected to drop their dancer off inside the studio doors and pick them up at the end of the designated camp time.

Emergency Closing
In the event of bad weather, updates will be posted on our Facebook and an email will be sent out. Camps will be rescheduled to a later date.

The person signing this form acknowledges that they have been given information on the studio policies and that they are responsible for reading and keeping up with all communications and policies throughout the year.
I attest that I have read the above tuition policy and agree to the terms of the policy:

WAIVER
All students and parents should recognize there is a risk of illness or injury inherent in any exercise, gymnastics or dance program. Further, no program of strenuous exercise should be undertaken contrary to the advice of a physician, or while suffering from any illness. All students should consult their physician before beginning any program of strenuous physical activity such as exercise, acrobatics or dance.
I understand Impulse Dance Academy is responsible for students during class time only. I hereby release, acquit, and agree to indemnify and hold harmless Impulse Dance Academy, LLC, its employees, agents, and its successors and assigns from any liability or claims of any kind whatsoever resulting or arising from my participation in any programs offered or sponsored by Impulse Dance Academy, LLC., or the participation therein of any of my children.

I've read the above and agree.

Covid Waiver

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Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
Impulse Dance Academy, LLC ("IDA") has put in place preventative measures to reduce the spread of COVID-19; however, IDA cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending IDA could increase your risk and your child(ren)'s risk of contracting COVID-19.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending IDA and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at IDA may result from the actions, omissions, or negligence of myself and others, including, but not limited to, IDA instructors, volunteers, and program participants and their families.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)'s attendance at IDA or participation in IDA programs ("Claims"). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless IDA, its instructors, volunteers, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of IDA, its instructors, volunteers, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any IDA classes or programs.

I've read the above and agree.

Photo Permission

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Online Payment Permission

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