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Have a kiddo interested in joining our Competition Acro Crew. Students must have their backbend kick-over to be considered for the Competition Team. Our Competition Acro Team will attend 2-3 Local Competitions this season. Evaluations will be August 12th 6:15PM.

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Fee per Family:

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Family Information

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

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info (Not Contact #1 or #2)*

Add New Student #1:

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	Student's First Name: *	Last Name: *
	Student Gender:	Birth Date: * (format=mm/dd/yyyy)
	Student Email:
	Grade Level 2019:*
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):
	Primary Doctor:

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.

Release of Liability
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.

Photography
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 are due on the 1st day of the month. If payments have not been made but the 7th, a $15.00 late fee will be added. Students whose tuition becomes more than one month behind may be withheld from attending any further classes until account is made current. The same tuition fee is charged as long as there are 3 -5 class periods offered that month. We do not offer pro-rating. Any retuned check will be charged an additional $30. I understand there will not be any refunds issued on any costumes, tuition, recital fees, competition fees, apparel or other fees that have been paid to the studio director.
I've read the above and agree.

Costume Fees
Costume Fees are Due with November Tuition and range from $50-$75.
There is a recital fee of $50/family will be due with the March Tuition. The Recital Fee covers one Recital T-shirt, 2 tickets for the show and recital participation.
I've read the above and agree.

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