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Take ANY 5 Adult Aerial, Dance, Fitness, or Pilates classes, expiration 12/31/2025
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* - denotes required fields |
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Family Information |
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Students entered below will be added to your family's account
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Add New Student #1:
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Add New Student #2:
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Add New Student #3:
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Add New Student #4:
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Add New Student #5:
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Additional Information: |
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Release of Liability
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I understand my responsibility for my property and the property of my children or those I am responsible for while at Dance Avondale's premises, including its parking lot. I will not hold Dance Avondale liable for any loss of property incurred at Dance Avondale or its host organization, Movement on Montrose, 2951 W. Montrose Ave.
I've read the above and agree.
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Assumption of Risk
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I understand the physical risks related to dance, cheer, resistance, acrobatics, and aerial training. I will not hold Dance Avondale or any of its affiliates responsible for any Dance Avondale-related injuries incurred in the studio setting or outside the studio setting as a result of participation in programming at Dance Avondale or its affiliates including its administrative team, its faculty, its staff, or its landlord called Montrose located at 2951 W. Montrose Ave. Chicago, 60618.
I've read the above and agree.
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Medical Emergency
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I hereby permit Dance Avondale to seek medical treatment for my child, legal guardian, or myself in case of emergency. I will not hold Dance Avondale, its executives, its faculty, its staff, or its affiliates including Movement on Montrose liable for costs related to injury or costs about the assessment of any injury or its healing based on participation in programming at Dance Avondale or attendance to a Dance Avondale event like Birthday Parties or other special occasions.
I've read the above and agree.
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Media Release
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I grant permission for photographs and video recordings of myself, my child, or students under my guardianship to be captured and used by Dance Avondale. I understand that these images and videos may be utilized in Dance Avondale’s marketing materials, promotional content, and digital or print media for purposes that support and enhance Dance Avondale's visibility and outreach efforts.
I've read the above and agree.
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Indemnification Clause
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The participant or guardian of the participant agrees to indemnify, defend, and hold harmless Dance Avondale, its owners, executive, faculty, staff, and affiliates from any and all claims, liabilities, damages, or expenses arising from participation in activities at Dance Avondale, except in cases of gross negligence or intentional misconduct by Dance Avondale. This includes, but is not limited to, claims related to personal injury, property damage, or other losses incurred during the event.
I've read the above and agree.
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Other Questions/Comments: |
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Credit Card Verification: |
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Card Number: * |
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Name as it appears on card: * |
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Nickname:
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Card Expiration Month: * |
Exp Year: *
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Address Line 1:
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Address Line 2:
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City:
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Zip:*
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