DE2 REGISTRATION

DE2 Registration 2019-2020

* Indicates required field

Student Name *

First

Last

Student Age *

Parent Name *

First

Last

Parent Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

First Class *

Second Class *

Photo Release: I, the undersigned, hereby give Dance Extreme 2.0, it’s agents, and/or assignees permission to use the photographs, motion pictures or any reproductions of the above student’s physical likeness taken of me in any manner it deems proper. I relinquish all rights, title, and interest I may have in the finished pictures, negatives and copies. I waive the right of prior approval to any finished products, advertising copy, or other matter or use that may be applied, and hereby release Dance Extreme 2.0, it’s agents, and /or assignees from any and all claims from damages of any and all kinds based on the use of said material. I hereby warrant that I am a parent or legal guardian of the subject of photography, who is under eighteen years of age, and am competent to act in his/her behalf insofar as the above is concerned.

Photo Release *

I have read and agree to the Photo Release (Please Check)

Liability Release: I do hereby agree to release Dance Extreme 2.0 and all other cooperating agencies, employees, officials, or managers thereof, from all liability for damages by reason of injuries or property damages that may be sustained as a result of participation in this program.

Liability Release *

I have Read and agree to the Liability Release (Please Check)

Policies:
-Classes will begin the beginning of September and will run through the end of June.
-Absences: Our classes are set up based on the season, and because of this we don’t offer tuition adjustments or make-up classes for absences. The monthly tuition remains the same, regardless if there are three, four or five classes within the month. Classes are NOT pro-rated.
-Tuition is due on the first of every month.
-Late Tuition will be assessed a fee of $10 after the 15th of the month.
-Students must attend class before any performance in order to participate in the following performance event. If too many classes are missed and the student is not proficient in the routine, the student will not perform with the class.
-Some performance events may require an entrance fee.
-Dress Code will be enforced. A student will be sent home if the dress code is not followed.
-Any disruptive students will be asked to leave the class.
-Class Rules: No gum, No cell phones, Dance Shoes Only, No sitting during class, No food in Classroom.
-A disrespectful and/or disruptive students and/or parents will be asked to leave the program as the instructor/owner/director sees fit.

Policies *

I have read and understand the policies set forth by Dance Extreme 2.0. I also understand if these policies are not followed, it may result in dismissal from the program and will require director approval to return. (Please Check)

Medical Waiver *

I authorize all medical and surgical treatment, X-ray, laboratory, anesthesia, and other medical and/or hospital procedures as may be performed or prescribed by the attending physician and/or paramedics for my child and waive my right to informed consent of treatment. **This waiver only applies only in the event the neither parent/guardian can be reached in the case of am emergency.** (Please Check)

Medical Consent *

In the event of injury, I hereby authorize the program officials of Dance Extreme 2.0 to arrange for medical services as may be deemed reasonable and necessary to the welfare of the injured, and I do hereby release Dance Extreme 2.0 and all others from all liability in taking action, including all action which may be contrary to personal religious beliefs. I, the undersigned, have read this release and consent to medical treatment and understand all its terms. I execute it voluntarily and with full knowledge of its significance. (Please Check)

Comment *

Submit

registration

DE2 Registration 2019-2020