|
|
|
|
| | |
|
|
|
|
Event: |
|
|
Start Date/Time: |
End Date/Time:
|
|
Fee per Student:
|
Room:
|
|
* - denotes required fields |
|
Family Information |
|
|
|
| | | |
| | | |
|
Students entered below will be added to your family's account
|
|
Add New Student #1:
(Show-Hide Details)
|
|
Add New Student #2:
(Show-Hide Details)
|
|
Add New Student #3:
(Show-Hide Details)
|
|
Add New Student #4:
(Show-Hide Details)
|
|
Add New Student #5:
(Show-Hide Details)
|
| | | |
|
Additional Information: |
|
| | | |
|
Registration & Payment Policy
(Show-Hide Details)
I, as parent or legal guardian of the previously named student, hereby register my child in the Fairytale Ballet Camp - Session 1 hosted by The Dance Club. I understand that a fee of $35.00 will be required at registration. I agree to pay a $30.00 fee for any check returned by the bank or credit card payment charged back to my account without due cause. Should collections become necessary, I hereby expressly agree to pay all the costs of collection including an additional collection fee of 35% whether or not the account is turned to an outside collection agency. I further agree to pay all court costs and attorneys fees should legal action become necessary.
I've read the above and agree.
|
|
|
Media Release
(Show-Hide Details)
I release THE DANCE CLUB and assign permission to license and use all images, video, and sound recordings of the previously named student in any media and for any purpose. I also agree that THE DANCE CLUB has all rights to any images, video and sound recordings for perpetuity. This agreement is irrevocable, worldwide, and perpetual.
I've read the above and agree.
|
|
|
Medical Emergencies
(Show-Hide Details)
I, as parent or legal guardian of the previously named student, hereby authorize THE DANCE CLUB and their agents to act in my behalf to provide emergency medical treatment for the previously named student. I further release THE DANCE CLUB from all liabilities insofar as the standard procedures are followed in dealing with my child. I also release THE DANCE CLUB and all staff and officials from any claims of damages or injury suffered by the previously named student in connection with or by their association with THE DANCE CLUB. This includes my heirs, who may not act in my behalf. This agreement is irrevocable, worldwide, and perpetual.
I've read the above and agree.
|
|
|
Cancellation Policy
(Show-Hide Details)
I agree that in the event that I need to cancel registration I will provide written notice at least 7 days prior to desired cancellation date, and furthermore agree to pay all expenses incurred upon notice of cancellation. I understand that I am responsible to pay all costs associated with any performing team my student may be part of for one full year regardless of participation.
I've read the above and agree.
|
|
|
Release of Liability
(Show-Hide Details)
I understand that there are risks involved with my child's participation in classes and events held at THE DANCE CLUB. I hereby waive and release THE DANCE CLUB and all staff, officials and affiliated entities from any claims of liability, damages or injury suffered by the registered student in connection with or by their association with THE DANCE CLUB. This includes my heirs, who may not act in my behalf.
I've read the above and agree.
|
|
| | | |
|
Other Questions/Comments: |
|
| | | |
|
Credit Card Verification: |
|
|
  
|
|
|
Card Number: * |
|
|
|
Name as it appears on card: * |
|
|
Nickname:
|
|
|
Card Expiration Month: * |
Exp Year: *
|
|
|
Address Line 1:
|
Address Line 2:
|
|
City:
|
State:
Zip:*
|
| | | |
|
Please Wait...
|
|
| |