Registration

Already a customer? Click here to login.

5 Week Session or Drop-In Class registration form. $15.00 per class. Click YES on the class which you would like to attend. Questions: Email info@livingartsdance.com. Please disregard the date at the top and use the dates in the checked box. Spring Session Classes: March 6 - April 15, no classes Easter week Spring Break April 3 - April 9.

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

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)*

Students entered below will be added to your family's account

Questions/Options:


Monday - Drop-In $15 Adult only Stretch & Strength 8 pm*
Tuesday - Not running due to low class registration. Adult Contemporary Ballet (Lyrical) 7pm*
Wednesday - Drop-In $15 House & Street Jazz 8 pm*
Thursday- Drop-In $15 Adult Hip-hop 8 pm*
Friday - Not running due to low class registration. Adult Tap 8 pm*
Friday - Drop-In $15 Adult African Dance 8 pm*
Saturday - Not running due to low class registration. Heels 7 pm*
DATE OF DROP-IN CLASS(ES)?*
NUMBER OF CLASSES ATTENDING (Ex. 1 Hip-hop class)?*
TOTAL PAYMENT AMOUNT DUE (Example: 1 class $15 per class, 2 classes $30 ):*

Additional Information:

Agreement

(Show-Hide Details)

I've read the above and agree.

Liability Waiver Part 1

(Show-Hide Details)

Living Arts Dance Inc.
624 N. Front Street, 2nd & 3rd Floor, Philadelphia, PA 19123
Release and Waiver of Liability and Indemnity Agreement
(Read Carefully Before Agreeing)
In consideration of being permitted to participate in any way in the Living Arts Dance Inc. indicated below and/or being permitted to enter for any purpose any restricted area (here in defined as any area where in admittance to the general public is prohibited), the parent(s) and/or legal guardian(s) of the minor participant named below agree:
1. The parent(s) and/or legal guardian(s) will instruct the minor participant that prior to participating in the below Living Arts Dance Inc. classes, activities or event, he or she should inspect the facilities and equipment to be used, and if he or she believes anything is unsafe, the participant should immediately advise the officials of such condition and refuse to participate. I understand and agreed that, if at any time, I feel anything to be UNSAFE, I will immediately take all precautions to avoid the unsafe area and REFUSE TO PARTICIPATE further.
2. I/WE fully understand and acknowledge that:
(a) There are risks and dangers associated with participation in Living Arts Dance Inc. classes, events and activities which could result in bodily injury partial and/or total disability, paralysis and death.
(b) The social and economic losses and/or damages, which could result from these risks and dangers described above, could be severe.
(c) These risks and dangers may be caused by the action, inaction or negligence of the participant or the action, inaction or negligence of others, including, but not limited to, the Releasees named below.
(d) There may be other risks not known to us or are not reasonably foreseeable at his time.
3. I/WE accept and assume such risks and responsibility for the losses and/or damages following such injury, disability, paralysis or death, however caused and whether caused in whole or in part by the negligence of the Releasees named below.
4. I/WE HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the Living Arts Dance Inc. facility used by the participant , including its owners, managers, promoters, lessees of premises used to conduct the Living Arts Dance Inc. classes, events or program, premises and event inspectors, underwriters, consultants and others who give recommendations, directions, or instructions to engage in risk evaluation or loss control activities regarding the Living Arts Dance Inc. facility or events held at such facility and each of them, their directors, officers, agents, employees, all for the purposes herein referred to as "Releasee"...FROM ALL LIABILITY TO THE UNDERSIGNED, my/our personal representatives, assigns, executors, heirs and next to kin FOR ANY AND ALL CLAIMS, DEMANDS, LOSSES OR DAMAGES AND ANY CLAIMS OR DEMANDS THEREFORE ON ACCOUNT OF ANY INJURY, INCLUDING BUT NOT LIMITED TO THE DEATH OF THE PARTICIPANT OR DAMAGE TO PROPERTY, ARISING OUT OF OR RELATING TO THE EVENT(S) CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEE OR OTHERWISE.
5. I/WE HEREBY acknowledge that THE ACTIVITIES OF THE EVENT(S) ARE VERY DANGEROUS and involve the risk of serious injury and/or death and/or property damage. Each of THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED OR INCREASED BY NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASEES.
6. EACH OF THE UNDERSIGNED further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the Province or State in which the event is conducted and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding continue in full legal force and effect.
7. On behalf of the participant and individually, the undersigned partner(s) and/or legal guardian(s) for the minor participant executes this Waiver and Release. If, despite thi

I've read the above and agree.

Liability Waiver Part 2

(Show-Hide Details)

I've read the above and agree.

Photo Release

(Show-Hide Details)

I've read the above and agree.

Enter your Full Name: