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Parents Night Out! Fundraiser for Dancers Against Cancer - Join us for a fun night of dancing, games & pizza.
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Fee per Student:
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Room:
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* - denotes required fields |
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Family Information |
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Students entered below will be added to your family's account
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Add New Student #1:
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Additional Information: |
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Tuition & Cancellation Policy
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Parents Night Out must be paid in full upon enrollment. There is a 25% cancellation charge on these fees. There are no refunds for cancellations within 10 days of September 13, 2024. If this Parents Night Out does not meet the minimum enrollment requirement it will be cancelled and a full refund will be given.
I've read the above and agree.
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Age Requirement
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Parents Night Out is for Ages 5 - 11.
I've read the above and agree.
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Release of Liability
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As the legal parent or guardian, myself, my spouse, and our respective heirs release and hold harmless Pegge Lee School of Dance Inc. dba Cabarrus Dance Academy, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Cabarrus Dance Academy, its owners and operators or in route to or from any of said premises. I further acknowledge and understand, appreciate and agree that my participation may result in possible exposure to illness from infectious diseases including but not limited to, MRSA, Influenza, and Covid-19. While personal discipline may reduce this risk, the risk of serious illness and death does exist. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releases or others and assume full responsibility for my participation and exposure. In the event that the student is not a minor, I warrant and agree that by signing below, I do hereby consent to the terms and conditions stated above and release on by own behalf as the student. I understand that it is my responsibility to consult with a physician prior to the student's participation to determine if the student is physically fit and does not have any medical condition that would prevent his/her full participation in Cabarrus Dance Academy programs. I agree to keep CDA staff informed of any health condition that could be affected by participation. I acknowledge that Cabarrus Dance Academy will not render any medical services to the student.
I've read the above and agree.
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Medical Emergency
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The undersigned gives permission to Pegge Lee School of Dance, Inc. dba Cabarrus Dance Academy, its owners and operators, staff, volunteers, 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, restrictions, or condition and/or declare the participant to be in good physical and mental health.
I've read the above and agree.
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Marketing Release
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I give Cabarrus Dance Academy, its employees and representatives permission to take photos or video of my child in connection with activities at the Academy, and give authorization to use and publish such media with or without name for any lawful purpose including publicity, advertising, and social media. To OPT OUT of Marketing Release for the Parents Night Out please contact the Studio Office.
I've read the above and agree.
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Other Questions/Comments: |
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Credit Card Verification: |
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Card Number: * |
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Name as it appears on card: * |
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Nickname:
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Card Expiration Month: * |
Exp Year: *
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Address Line 1:
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Address Line 2:
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City:
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State:
Zip:*
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