Registration

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Event:

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End Date/Time:

Fee per Student:

Room:

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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

Additional Information:

Assumption of Risk & Waiver of Liability

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Tula Movement Arts, LLC
I hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE Tula Movement Arts , LLC, its officers, executives, agents, employees and/or other affiliated persons (hereinafter referred to as RELEASEES) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by my child, or to any property belonging to my child, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES or otherwise, while participating in such activity, or while in, on or upon the premises where the activity is being conducted or in transportation to and from said premises.

I HEREBY AGREE TO INDEMNIFY TULA MOVEMENT ARTS, LLC FROM AND ALL LIABILITY, LOSS, COSTS, CLAIMS, FEES, JUDGMENTS, OR DAMAGE TULA MOVEMENT ARTS, LLC MAY SUFFER ARISING OUT OF OR RELATED TO, OR ON BEHALF, OR BECAUSE, OF MY CHILD’S ACTIONS OR INACTIONS, OR BY A THIRD PARTY, OR AS A RESULT OF THE NEGLIGENCE, GROSS NEGLIGENCE OR DEFAULT OF TULA MOVEMENT ARTS, LLC. AS CONSIDERATION FOR MY CHILD BEING PERMITTED TO PARTICIPATE IN TODAY’S ACTIVITIES I AGREE TO FOREVER RELEASE, DISCHARGE, AND HOLD HARMLESS FROM ANY LEGAL AND/OR OTHER LIABILITY AND AGREE NOT TO SUE TULA MOVEMENT, LLC, ITS EMPLOYEES, AGENTS, REPRESENTATIVES, MEMBERS, SHAREHOLDERS, OFFICERS, DIRECTORS, COORDINATOR, STAFF, PARENTS, VOLUNTEERS, ASSIGNS, HEIRS, NEXT OF KIN, AND/OR ESTATES (HEREAFTER COLLECTIVELY TULA MOVEMENT, LLC) ARISING OUT OF ANY LIABILITY, COSTS, FEES, DAMAGES, JUDGMENTS, INJURIES, PHYSICAL OR PSYCHOLOGICAL, DEATH , OR PERSONAL OR REAL PROPERTY DAMAGE RESULTING FROM MY CHILD’S PARTICIPATION IN TODAY’S ACTIVITIES WHETHER OR NOT SUCH LIABILITY COSTS, FEES, DAMAGES, INJURY, OR DEATH WAS CAUSE BY THE NEGLIGENCE AND GROSS NEGLIGENCE, ACTIVE OR PASSIVE, OR DEFAULT OF TULA MOVEMENT, LLC.

IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Waiver of Liability understand it and sign it voluntarily as my own free act and deed; no oral representations, statements or inducements, apart from the foregoing written agreement, have been made; I execute this Release for full, adequate and complete consideration fully intending to be bound by same.

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Payment

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Pickup/Drop off

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