Registration

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Boys & girls are invited to join us for our Build-A-Dancer Winter Camp! Based off the music & sounds of "Frozen," dancers will build self-confidence, gain independence, and boost social skills in a family-friendly environment. Camp includes games, dancing, arts & crafts, and storytelling! Parents, please send your dancers in dance clothes/themed clothes and with a peanut-free snack.

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Family Information

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

	Address: *
	City: *	State: * Zip: *

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RDA Policies & Procedures

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To ensure a smooth and enjoyable experience for everyone at Revolutions Dance Academy, RDA, (operated by MST Xoros LLC), we kindly ask that you review and agree to the following policies and procedures. Property Damage: Anyone causing damage to RDA property will be held financially responsible. Lost and Found: RDA is not responsible for lost or stolen items. Please mark all belongings clearly with your child's name. Video Surveillance: Please be aware that RDA utilizes video/audio camera surveillance throughout the facility. This footage may include you, your child/children, and guests. As the legal parent/guardian, I hereby release and hold harmless RDA (operated by MST Xoros LLC), its owners operators, employees, and representatives from any and all liability, claims, demands, and causes of action whatsoever arising out of or related to any loss, damage, or injury sustained by my child (the participant) and/or myself while: (1) In or upon the premises of RDA or any premises under its control and supervision. (2) In route to or from any of the aforementioned premises. As the legal parent or guardian, I understand that RDA (operated by MST Xoros LLC) may publish photographs and videos of me or my child in print, electronic, or video format. This includes, but is not limited to, the academy website, social media platforms, promotional materials, and brochures. I understand that I will not receive any financial compensation for the use of these images. I release MST Xoros LLC, its owners, and operators from any claims related to copyright ownership, publication of the images, or use of the images (including any claim for compensation). If you DO NOT want photographs or videos of your child to be used, you can opt-out by submitting an email request to info@dancerda.com. The email subject line should be "NO MEDIA USAGE" and must include your child's name and your signature (typed name is acceptable). As a condition of your child's participation in RDA (operated by MST Xoros LLC), I, the parent/guardian, acknowledge and agree to the following: (1) In the event of a medical emergency and if you cannot be reached, RDA staff are authorized to obtain necessary medical treatment for your child. (2) I understand that limited medical information about my child may be shared with medical personnel solely for the purpose of providing appropriate emergency care. (3) T o ensure the safety and well-being of my child, I will disclose any necessary medical information including, but not limited to, physical limitations or restrictions, allergies, and current medications. By agreeing to this policy, I acknowledge that, to the best of my knowledge, my child is in good physical and mental health and is capable of participating safely in dance activities offered by Revolutions Dance Academy.

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