Come on in to our "Open Gym" time to get extra practice on your skills. Open gym is available to anyone ages 5 -18yrs. Each open gym visit is $11.00. If you are a non-member you must have a waiver prior to your open gym time. All open gyms are 1 hour. Coaches are available to spot. This is not the same as a regular instructed class. It is more of individual workouts on what the student is specifically wanting to work on for this hour.
Start Date/Time: End Date/Time:
Fee per Family: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
Address: *
City: * State: * Zip: *
Emergency Contact Info
(Not Contact #1 or #2)*
What skills is your tumbler wanting to focus on?
Additional Information:
Assumption of Risk
I understand that participating in Dance and Acro classes are physical activities where injury may occur and I agree to assume all responsibility including insurance coverage for myself and/or my child to cover any such incurred injuries which may arise from any class or event associated with Miss Lisa's Dance Express LLC on or off the actual premises. The undersigned gives permission to Miss Lisa's Dance Express LLC, its owners and operators to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I hereby declare any physical/mental problems, restictions, or condition and/or declare the participant to be in good physical and mental health.This contract is binding through July 31st, 2020.
I've read the above and agree.
All information is current and accurate regarding this child. I understand that once my child has been released to one of the individuals listed above, Miss Lisa's Dance Express LLC assumes no responsibility for the welfare of the child. Miss Lisa's Dance Express LLC is not responsible for any damages and/or injuries, but it is the responsibility of the parent/guardian. I hereby agree to hold and indemnify Miss Lisa's Dance Express LLC, its officers, agents, instructors and employees on any and all claims, demands, actions, legal fees, medical expenses, and costs for bodily damages arising out of my or my child's participation in dance class, while waiting before or after any type of class, or participating in any other type of class offered or in any action or activities associated therewith.
I hereby acknowledge that in consideration of myself or my child being permitted to participate in any class or activity at Miss Lisa's Dance Express LLC. I expressly agree to assume the risk of any bodily injury or other damages resulting there from. I also agree and understand that physical contact may occur within making corrections and permit this for instructional (not behavioral) purposes. This contract is binding through July 31st, 2020.

I've read the above and agree.
I hereby grant to Miss Lisa's Dance Express LLC, the irrevocable and unrestricted right to use, reproduce, and publish photographs or videos from classroom, performances, or competition of myself or my child for editorial, trade, advertising, or any other purpose or manner and medium. I hereby release Miss Lisa's Dance Express LLC, and its owners and teachers from any and all claims, actions, and liability relating to its use of said photographs and videos. This contract is binding through July 31st, 2020.
I've read the above and agree.
Payment Policy
All payments for open gym are due on or before the gym time.
I've read the above and agree.
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Other Questions/Comments: