Registration
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Waitlist for Camp #2 Completion of this form puts you on the waitlist for camp. No payment is required. We will be contacting you if a space becomes available. Thank you so much.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
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Family Information
First Name:
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Last Name:
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Type
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Caregiver
Father
Guardian
Mother
Parent
Self
Home Phone:
Cell #:
Work #:
Email:
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(Emails are kept confidential)
Address:
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City:
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State:
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Zip:
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Students entered below will be added to your family's account
Add New Student #1:
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Student's First Name:
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Last Name:
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Birth Date:
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(format=mm/dd/yyyy)
Add New Student #2:
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Student's First Name:
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Last Name:
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Birth Date:
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(format=mm/dd/yyyy)
Add New Student #3:
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Student's First Name:
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Last Name:
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Birth Date:
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(format=mm/dd/yyyy)
Add New Student #4:
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Student's First Name:
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Last Name:
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Birth Date:
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(format=mm/dd/yyyy)
Add New Student #5:
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Student's First Name:
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Last Name:
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Birth Date:
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(format=mm/dd/yyyy)
Questions/Options:
Child's First Name
Child's Last Name
T-shirt Size (XSC, SC, MC, LC)
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Additional Information:
TUITION, TRANSFERS & WAITLISTS
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2021 TUITION, TRANSFERS & WAITLIST POLICIES
This year camp space will be very limited. T here are NO refunds on 2021 camp enrollments.
TUITION:
Tuition will be paid via PayPal invoice after enrollment. The registration process does not include payment. Please pay your PayPal invoice within 24 hours of being received to confirm your child's spot in camp.
TRANSFERS:
Camp transfers are only based on availability within the 2021 season.
WAITLISTS:
If there is no room available in your desired camp, you can sign up on the waitlist. No payment is required for a waitlisted spot.
Little Princess Academy and Sierra Madre Dance Center operate independently and pervious studio credits cannot be applied to camp tuitions.
I've read the above and agree.
RELEASE WAIVER AND LIABILITY
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Release and Waiver of Liability
PLEASE READ THIS CAREFULLY. THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR AND YOUR CHILD’S LEGAL RIGHTS.
Participant desires to participate in certain dance classes and activities of Sierra Madre Dance Center (“SMDC”) and assures that he/she is in proper physical condition to take part in dance classes and activities at SMDC. Participant understands that there are risks of physical injury associated with, arising out of, and inherent to dancing and activities associated therewith. Participant understands that such risks simply cannot be eliminated, despite the use of safety, without jeopardizing the essential qualities of the activity. In recognition of this acknowledged risk of injury, and in consideration of being accepted into such dance classes or activities Participant hereby freely, voluntarily and without duress executes this release and waiver of liability under the following terms:
1. Release and Waiver?. Participant does hereby release and forever discharge and hold harmless SMDC, its owners, operators, members, employees and agents for any and all claims or demands for damages, loss of services, costs, expenses, and causes of actions whatsoever, in any way resulting from any and all injury to Participant or property of Participant arising directly or indirectly out of Participant’s participation in any and all activities of SMDC including, but not limited to, dance classes, competitions, travel to and from competitions or performances, and any and all activities associated or performed in conjunction with SMDC. Participant understands that this Release discharges SMDC from any liability or claim that the Participant may have against SMDC with respect to any bodily injury, personal injury, illness, death, or property loss or damage that may result from Participant’s activities with SMDC, whether caused by the negligence of SMDC or its Members, employees, agents or otherwise. Participant also understands that SMDC does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to, medical, health, or disability insurance in the event of injury or illness
2. Indemnification?. Participant agrees to indemnify and hold forever harmless SMDC, its Members, employees and agents from any and all injuries, damages, costs and attorney’s fees whatsoever which may arise out of the Participant’s participation in any SMDC activity or presence on the premises of the dance studio.
3. Acceptance of Inherent Risk?: ?Participant expressly accepts and assumes all of the risks inherent in this activity or that might have been caused by the negligence of SMDC. My participation or my child's participation in this activity is purely voluntary and I elect to participate or allow my child to participate despite the risks. In addition, if at any time I believe that event conditions are unsafe or that I or my child am unable to participate due
to physical or medical conditions, then I or my child will immediately discontinue participation.
4. Medical Treatment?. ?I, the undersigned parent or guardian of the Participant, hereby authorize SMDC and its owners, employees, independent contractors and other agents to consent to and authorize the emergency medical treatment of the below named Participant by a physician duly licensed under the provisions of the California Medical Practice Act or by a dentist duly licensed under the California Dental Practice Act. I understand that this Consent to Emergency Medical and Dental Treatment will be used by the SMDC only if it is unable to reach me within a reasonable period of time given the circumstances of the emergency. On behalf of myself, any other parents/guardians, and Participant, I forever release SMDC and its owners, employees, independent contractors and other agents from any and all liability related to the exercise of the authorization provided herein.
5. Insurance?. Participant underst
I've read the above and agree.
COVID RELEASE - PARTICIPANT AGREEMENT
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PARENT AND PARTICIPANT AGREEMENT
To All Sierra Madre Dance Center (“SMDC”) Participants, Parents, and Families,
We, at SMDC, are extremely excited and eager to get back to training in the studio. As we navigate through this uncertain and difficult time, we are committed to providing a safe environment for all the participants, staff, and families as we return to our dance activities in some capacity.
As we begin to return to our in-studio dance classes, we will follow some extremely strict protocols and procedures to protect the participants, staff, and families involved and will ask each family to agree to follow the following guidelines to help keep everyone healthy.
Parent Protocols:
? If you are not comfortable, DO NOT return to in-studio participation. It is the parent’s decision when your child returns to the studio. SMDC is also offering Zoom participation as an alternative for in-person dance classes.
? Parents should assess the level of risk to their child[ren], such as children who may have asthma, diabetes, or other health problems.
? Review and adhere to the SMDC’s protocols and inform your child on the respective requirements for participation.
? Please provide any participant with a face mask. Students will be asked to wear masks at appropriate times (e.g., when
entering class, stretching, and when leaving class).
? Conduct a temperature check of your child for low grade fever (>100.4°F) before class.
? If you or your child or anyone in your household has any type of fever, ?DO NOT GO TO? ?CLASS?.
? Do not go to SMDC facilities with any of the CDC and/or CDPH COVID-19 symptoms.
? If you, your child, or anyone in your household has any CDC and/or CDPH COVID-19 symptoms, speak to a physician and
follow CDC and/or CDPH COVID-19 guidelines on self-quarantine.
? Notify SMDC immediately if you or your child or anyone in your household becomes ill with COVID-19 symptoms as stated
by the CDC and/or CDPH COVID-19 for any reason.
? If you or your child or anyone in your household has tested positive for COVID-19, written confirmation of COVID-19
negative status and clearance from your physician must be provided to SMDC for return to full participation in the studio.
? You acknowledge that should you or anyone in your household test positive for COVID-19, SMDC can inform other
parents/participants of a potential exposure to COVID-19 - although such information shall not include any names.
? Ensure participant’s clothing is washed after every session.
? Ensure all equipment is sanitized before and after every training session.
? If possible, supply participant with individual sanitizer.
? Ensure participant has plenty of water.
? Follow all drop-off and pick-up procedures provided by SMDC and maintain appropriate social distancing protocols when
doing so.
? Wear face-masks whenever on SMDC property.
Participant Protocols:
? If you are not comfortable, DO NOT return to in-studio participation. You may participate by Zoom video conference.
? Review and adhere to the SMDC’s protocols on the respective requirements for participation.
? Wash hands/sanitize hands thoroughly before and after every session.
? Wash and sanitize training equipment/clothes after every session.
? Wear a face mask to class, when leaving or whenever asked to wear it in class.
? Do not share water, food, or equipment.
? Respect and practice social distancing – and follow directions provided in class for social distancing.
? Place equipment, bags, etc. at least 6 feet apart.
? No high 5’s, handshakes, knuckles or group celebrations.
? Notify your teacher immediately if you are feeling ill or notice someone else who is ill.
General Hygiene Protocols:
Parent and Participant further recognize that the following practices generally help to mitigate transmission of any infectious/communicable disease.
? Avoid touching your face.
? Frequently wash hands with soap and water for at least 20 seconds or use an alcohol-based h
I've read the above and agree.
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