Registration

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Join us for an Attitude of Gratitude Family Dance Party! Snacks and drinks provided, plus get your cool kid attitude on with a family hip hop class from 4:15-5:00 followed by a grateful dance party until 6pm. Proceeds will be donated to the Leukemia & Lymphoma Society, a group dear to the Monarch family! $20 suggested donation per family! Weather permitting, we will open our windows and rolling door to allow an extra dose of fresh air. Wear your comfy clothes and bring a clean pair of sneakers for the dance floor!

Event:

Start Date/Time:

End Date/Time:

Fee per Family:

Room:

* - denotes required fields

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): Names, Phone Number, Relationship to Students*

Questions/Options:


Proceeds from the Attitude of Gratitude Dance Party will benefit the Leukemia & Lymphoma Society. We suggest a donation of $20 per family. How much would you like us to charge your card? *

Additional Information:

Assumption of Risk & Release of Liability

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I for myself and my child or ward ("Participant") HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY WAY IN ANY PHYSICAL ACTIVITY LEAD OR DIRECTED BY ANY EMPLOYEE, VOLUNTEER, OR AGENT OF MONARCH MOVEMENT, LLC (collectively, "Releasees"), whether in person or remotely via live or recorded video, whether online or via other mechanisms, including any risks that may arise from negligence or carelessness of any kind whatsoever on the part of Releasees. I certify that Participant is physically fit and has not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude Participant's participation in this activity or event. I acknowledge that the activities provided by Releasees contain inherent risk and voluntarily assume that risk.

DANCE SHOES SHOULD ONLY BE WORN ON SURFACES SPECIFICALLY DESIGNED AND DESIGNATED FOR DANCING. If Participant is not engaging in activity on a floor designed for dancing, Participant should wear appropriate shoes. If I am unsure about whether the surface is specifically designed or designated for dancing, I will inquire about it from Releasees. I specifically waive all liability against Releasees for injury incurred by Participant using inappropriate foot attire.

In consideration of my enrollment and permitting Participant to participate in this event, I hereby take action for Participant, Participant's executors, administrators, heirs, next of kin, successors, and assigns as follows:

I WAIVE, RELEASE, AND DISCHARGE Releasees from any and all liability, including but not limited to, liability arising from the negligence or fault for disability, personal injury, property damage, property theft, death, or actions of any kind which may hereafter occur to Participant including Participant traveling to and from the any premises any physical activity is held at.

I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE Releasees for any and all liabilities or claims made as a result of participation in this activity or event, whether caused by the negligence of Releasees or otherwise.

I hereby consent Participant to receive medical treatment which may be deemed advisable at the discretion of Releasees in the event of injury, accident, and/or illness during any activity or event held by Releasees. I consent to Participant receiving this medical treatment whether provided by Releasees or EMS/Emergency Personnel and will hold Releasees harmless for any injury incurred during medical treatment.

I agree to provide updated emergency contact information for the participant(s).

I understand that at this event or related activities, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers, and assigns. The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

This waiver shall be construed according to the laws of the State of North Carolina. I agree to bring any lawsuit against Releasees in the state court in Orange County, North Carolina.

I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.

I've read the above and agree.

Covid & Illness Policies

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ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT
In consideration of myself or my child or child in my legal care being allowed to participate on behalf of Monarch Movement Company studio programming and related events and activities, the registrant or guardian thereof acknowledges, appreciates, and agrees that:

1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS (insert name of sports organization) their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("RELEASEES"), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY CLICKING AGREE, AND ACGREE FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Additionally I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child's/ward's presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.

5. Monarch Movement Company will generally follow the masking guidelines utilized by Orange County Schools for indoor classes and any Orange County mandates for outdoor classes. Monarch Movement Company may determine an alternative masking policy based on CDC guidance. Students and families must comply with any and all masking requirements made by Monarch Movement Company at events on or off site.

6. Students and caregivers entering the studio must submit to a temperature screening and may be asked to leave the studio if they present with a fever. The studio is happy to arrange a makeup class.

7. If a student or household member has been diagnosed with Covid-19 or other contagious illnesses or is exhibiting signs of such illnesses, do not attend class. The studio is happy to arrange make-up classes.

8. Students and families should consider masking if they are exhibiting signs of any respiratory illness to slow or stop the spread of common colds and flus.

I've read the above and agree.

Photo Release

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I've read the above and agree.

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