I understand that dance classes may include, without limitation, dancing with props, stretching, barre work, across the floor combinations, acrobatic activities, tumbling activities, dance routines in the center, and other related activities. I further understand that all of the activities of the dance class involve some degree of risk of strain or bodily injury. DANCE EXTREME ACADEMY, LLC is not responsible for personal property.
I agree to be responsible for reading studio correspondence and respecting deadlines, if applicable.
I hereby acknowledge that I have read the statements above and agree to participate accordingly. I agree that I must execute the Release and Waiver of Liability and Indemnity Agreement below as a condition-precedent to participating in any program whatsoever related to DANCE EXTREME ACADEMY, LLC, including participating in introductory programs, classes, special events, and that this Agreement and the Indemnity Agreement below applies to all activities related to DANCE EXTREME ACADEMY, LLC, regardless of whether said activity is at its normal place of business or another location.
I understand that the Program will include, without limitation, travel to-from and around (location), accommodations at (hotel), (recreational activities). Further, I understand that the program may include acrobatic activities and may involve the instruction by special or master instructors as well. I agree that this Agreement must be executed as a condition-precedent to participating in any program whatsoever related to DANCE EXTREME ACADEMY, LLC, including participating in introductory programs, classes, special events, and that this Agreement and the Indemnity Agreement below applies to all activities related to DANCE EXTREME ACADEMY, LLC, regardless of whether said activity is at its normal place of business or another location. This Agreement applies for the entire duration of the participant's participation with DANCE EXTREME ACADEMY, LLC.
Knowing the risks inherent in the activities offered by DANCE EXTREME ACADEMY, LLC., and in consideration of the participant's participation in the program:
I certify that I am the parent or legal guardian of who is a minor, or that as an adult participant, I am competent to enter this agreement ("Participant). As consideration for Participant being allowed to participate in the programs and activities offered at DANCE EXTREME ACADEMY, LLC, I agree to release, waive, discharge and covenant not to sue DANCE EXTREME ACADEMY, LLC, or Chelsea Place Center, LLC along with its officers, directors, board members, supervisors, agents, servants or employees (collectively referred to here as "release") from any and all liabilities, claims, demands, or causes of action that may arise from or be related to any loss, damage, or injury, including death, that may be sustained by my Participant or Participant's personal property while Participant is participating in Dance Extreme Academy's programs or activities or while participant is on the premises on which Dance Extreme Academy, LLC, and Chelsea Place Center, LLC is located.
To the best of my knowledge, Participant is in good physical condition and I have no knowledge of any physical condition, injury, or illness whatsoever which would place Participant at risk to participate in DANCE EXTREME ACADEMY, LLC, programs and activities. I understand that the Program will include, without limitation, travel to-from and around (location), accommodations at (hotel), (recreational activities). Further, I understand that the program may include acrobatic activities and may involve the instruction by special or master instructors as well.
I am fully aware of the risks connected with participating in the programs and activities at DANCE EXTREME ACADEMY, LLC. I voluntarily assume full responsibility for any risk of loss, property damage, or personal injury, including death, that Participant may sustain as a result of participating in DANCE EXTREME ACADEMY, LLC, programs and activities, however caused. I further agree to indemnify and hold harmless the release from any loss, liability, damage or cost, including court costs and attorneys' fees, that may accrue related to my child's participation in DANCE EXTREME ACADEMY, LLC, programs and activities, however caused.
While my child is attending programs at DANCE EXTREME ACADEMY, LLC, I give permission for the staff of DANCE EXTREME ACADEMY, LLC, to administer appropriate medical attention to Participant in the event of any accident, illness, or injury. I will be responsible for any and all costs of medical care and treatment that may be provided, except for care and treatment covered by my insurance. This instrument shall be binding upon the members of my family, my spouse, and my heirs, assigns and personal representatives.
This instrument shall be governed by the laws of the State of Florida. Exclusive Venue shall be in the Sixth Judicial Circuit, New Port Richey, Pasco County, Florida. The parties hereto expressly waive the right to a trial by jury.
I certify that I have read and fully understand the above waiver and consent form. I certify that I am signing this form freely and voluntarily and that I understand that by signing this form I am giving up substantial rights. I certify that all blanks or statements requiring insertion or completion were filled in before I signed.
Dance Extreme Academy provides access to certain equipment as part of its students' and guests' participation in the programs available at Dance Extreme Academy. Said equipment can include, but is not limited to, tumbling tracks and other dance and gymnastics related equipment. For you and/or your child to utilize said equipment, you agree to be bound by the following terms and accept the following risks as described herein. As the participant, parent, and/or legal guardian of [child], recognize that any athletic activity could potentially cause severe injuries including sprains, strains, broken bones, permanent paralysis, or death. These risks may increase with the use of gymnastics equipment based on the movements associated with the activities and the height of the equipment. I have the legal authority to waive any and all liability associated with these activities and use of the equipment located at Dance Extreme Academy. I understand these risks as they apply to myself and I have discussed the matter with the participants and have explained to the participant (if that participant is someone other than myself) the necessity of following all instructions at Dance Extreme Academy including all written and oral instructions.
I hereby forever release Dance Extreme Academy, LLC and Chelsea Place, LLC, including all instructors and staff, from all liability for any damages or injuries that may occur as a result of any activities associated with Dance Extreme Academy, LLC, and/or Chelsea Place, LLC. I have the legal authority to bind any participants listed on this agreement or any other agreements I have executed with Dance Extreme Academy and I agree to indemnify and hold Dance Extreme Academy and Chelsea Place harmless should I misrepresent my authority to bind any and all listed participants.
I further understand that this is a waiver of liability form intended to release Dance Extreme Academy and Chelsea Place from all liability of any nature, that I have read it or had an opportunity to read it, that I understand the contents, and that my agreement attached hereto represents my free and voluntarily acceptance of the terms herein.
Please acknowledge the following :
• I understand that there is not pro-rating of tuition for any reason, including missed classes, vacation, illness or holiday. You WILL have the option of making up classes that you are absent from.
• I understand that the registration fee is NON-REFUNDABLE and due at the time of enrollment.
• I understand that if my tuition does not process automatically on the 1st of the month due to NSF or Invalid account or any other reason, my account will be charged a $5 fee in order to reprocess payment.
• I understand that tuition will be automatically charged on the 1st of every month. If for any reason, your card/e-check does not process by the 7th of the month, a $10 late fee will be added. Remember that it is your responsibility to update your card information when needed.
• I understand that if a charge gets returned, for any reason that is not fault of Dance Extreme Academy, a $25 return fee will be charged to your account.
• I understand that only monthly re-occurring fee's will be charged to my account. (Costume Fee's, Recital Fee's must be paid by cash/check at the front desk)
• I understand that the Recital Costume Fee is due by November 1st, 2018. This fee is NON-REFUNDABLE and NON-TRANSFERABLE. A $10 late fee, per costume, per month will be added to your account starting on December 1, 2018.
• I understand that the Recital Fee (fee varies on package chosen) is NON-REFUNDABLE and due by April 1st, 2019.
• I understand that I will NOT receive my Recital Costume and/or participate in the Recital I if my account is not at a zero balance and my Recital Fee has not been paid.
• I understand that the Dance Extreme Academy will provide communication through the following methods...Monthly Newsletters via email, Website, Facebook, Instagram, Texts (on rare occasions) and Postings on the bulletin boards at studio. We ask that the main way to reach out to us is through our email email@example.com We try to respond within 24 hours.
• I understand that attendance is very important. During the months of April & May, if your child is absent a day in which choreography is being taught, you might be required to book a private lesson. This will enable your child to get caught up on what he/she missed. If your child has too many absences during these months, it can be at the teacher's discretion to pull them from the recital dance without refund.
• Any non competition student wanting to compete a solo must agree to Soloist agreement. (Email for information)
Parent Release Form for Media Recording
I do hereby grant permission to Dance Extreme Academy to use the image of my child. Such use includes the display, distribution, publication, transmission and/or otherwise use of photographs, images, and/or video taken of my child for use in materials that include, but may not be limited to printed materials such as brochure and newsletters, advertising, videos and digital images such as those on the studio's website and Facebook/Instagram pages. By agreeing to this I understand that I am giving unrestricted permission for my child's image to be used in print, video and digital media. I agree that these images may be used by Dance Extreme Academy without further notifying me. I do understand that the child's names may not be used in conjunction with any video or digital images.
Anyone wishing not to agree, must send us a separate email.