Registration & Consent Form

Parent/Guardian Information

• Number of Students123+

Student Information

• Dance ExperienceYesNo

Additional Student Information (If Necessary)

• Dance ExperienceYesNo

Additional Student Information (If Necessary)

• Dance ExperienceYesNo

Emergency Contact Information

Acknowledgements & Consent

• ACKNOWLEDGEMENT OF RISK
  Participating in dance class or any related event always runs the risk of personal injury and loss or theft of personal property. The purpose of this acknowledgement is for you to understand that there is a possibility of personal injury or property damage beyond the control of Eastside Dance Project LLC staff and faculty. Eastside Dance Project LLC, its employees/independent contractors is/are not responsible for personal injury and loss or theft of property. By signing this form you are acknowledging that you have read and understand the risks and liabilities of participation. Acknowledged

• MEDICAL TREATMENT
  I further authorize Eastside Dance Project LLC to seek medical treatment at the nearest medical facility and they may call paramedics and discharge me/my student to an ambulance if I am not able to authorize it, in the case of an emergency. Observance of all COVID-19 protocols and social distancing regulations must be observed throughout the duration of the program. I certify that my child/dancer is in good health and capable of participating in physical activities. Acknowledged

• PARTICIPATION & PHOTOGRAPH CONSENT
  I agree that all matters concerning lack of attendance, progress in class or financial difficulty will be discussed with and final determination will be made by the Program Director with input from the faculty. I agree that it is my responsibility to submit a written request if it becomes necessary to withdraw my child from any Eastside Dance Project program. I understand that until I submit a written request, I will continue to be liable for all continuing costs for all activities. I hereby give my permission to Eastside Dance Project LLC to take and use photographs for promotional uses for the studio. Acknowledged

• PAYMENT & REFUND POLICY
  I understand that the registration fee ($25) included in the tuition is non-refundable. Tuition fees must be paid in full by Monday, July 5, 2021. I understand that if any fees are not paid according to the registration agreement my child will not be allowed to participate in any class or activity and will be removed from the program until fees are paid in full. Please review additional payment refund schedule (below) for participation in (2) or (3) sessions. Acknowledged

I have read this document in its entirety, and sign below as I am in agreement with Eastside Dance Project LLC’s policies. I further certify that the information I have provided on this form is all accurate and true to best of my understanding and knowledge. I hereby sign this document understanding I am entering into contract with Eastside Dance Project, LLC. Acknowledged