Winter Snow Dance Camp for ages 3-6 includes dance, crafts, and games. The cost for the camp is $20.00 per student. The fee will be processed to your credit card within 24-48 hours after your registration is received.
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Last Name
First Name:* Last Name: *
Relationship to Student*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
Address: *
City: * State: * Zip: *
Emergency Contact Info (Not Contact 1 or 2)*
Students entered below will be added to your family's account
Additional Information:
Assumption of Risk and Release
I understand that dance & gymnastics are physical activities that could cause injury. The risk of injury while participating is significant including the potential for permanent paralysis and death, and while the guidelines, equipment and personal discipline may reduce this risk, the risk of serious injury does exist and I KNOWINGLY AND FREELY AM ALLOWING MY CHILD(REN) TO PARTICIPATE AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEE or others, and assume full responsibility for my child(ren)’s participation. I for myself, my children and on behalf of my heirs, assigns, personal representative, and next of kin, HEREBY RELEASE, INDEMNIFY AND HOLD HARMLESS JMAD, their officers, officials, agents and/or employees, teachers, other participants, sponsoring agencies, sponsors, advertisers and, if applicable, owners and lessors of premises used to conduct activities, classes and/or events (RELEASEES), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASES OR OTHERWISE, to the fullest extent permitted by law arising from JMAD’s activities. “Activities” include all in-house activities, as well as off-site activities, including, but not limited to nursing home shows, recitals, and rehearsals.
I've read the above and agree.
I understand that photographs and/or videos of my child/children and/or their class(es)/events may be taken for the promotion of the JMAD. I agree that they may be used for, but not limited to brochures, literature, newspaper advertising, website, social media accounts, etc. No compensation will be provided for such use. I understand that my child's name will not be included with the photographs, unless the director of JMAD obtains separate permission from me.
I've read the above and agree.
Enter your Full Name: *   
Other Questions/Comments:
Credit Card Verification:
Card Number: *  
Name as it appears on card: *
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*