INSURANCE WAIVER and RELEASE OF LIABILITY FORM

PLEASE READ CAREFULLY AND COMPLETE

This form serves as an agreement stating you understand and agree with our studio policies for the 2023-2024 School year.

* Required fields
Name *
E-mail Address *
Today's Date *
Dancer's Name: *
Dancer's Birthdate *
Grade Entering this school Year *
Aging turning this school year (September- August) *
Gender *
Pronoun *
Parent's/Guardian's Name(s): *
Parent's Email: *
Address *
City/ State/ Zip Code *
Home #: *
Cell #: *
Work #: *
I am signing this waiver for the following students: (Please list all student's names in the space below) *
The Following are the policies set forth by To The Pointe of Performing Arts, it's Directors, Owners, and Staff. All dancers and Guardians must abide by these rules in order for them or their children to participate in dance lessons and performances at To The Pointe of Performing Arts Inc. *

I agree and understand
Tuition is an annual rate broken down into 10 even monthly payments which must be paid by the 7th of the month or a $15 Late fee will be assessed. Regardless of the amount of weeks in any given month, the tuition WILL ALWAYS BE THE SAME AMOUNT. *

I agree and understand
Refunds/Credits are NOT GIVEN for classes missed once tuition has been paid for a given month. Classes must be completed for that month. If I wish to discontinue dancing, I must notified the studio by the 23rd of the month previous to the month in which I or my child wishes to stop dancing. Dancers may view or take classes virtually if they are home sick or quarantined due to Covid-19. Refunds will not be given out regardless of reason for missing classes. *

I agree and understand
In the event that the studio is forced to go virtual by the state, tuition will not be refunded or credited for the month that we are currently in. Since we are continuing to offer classes via Zoom, we ask that all dancers continue to stay in class and participate to continue their progress. After the current month, dancers are welcome to discontinue as long as tuition has not been paid for. *

I agree and understand
Costume deposits must be paid as follows: $25 deposit per dancer in October, November, December. After ordering the costumes, 1/2 of balance is due in January and final 1/2 of balance must be paid in February. All costume balances must be paid in full by Feb. 7th or a $25 Late fee will be assessed. *

I agree and understand
All Tuition and costume payments must be made via AUTO CHARGE which I will sign up for. The monthly amounts will be automatically taken out of my account on the 23rd-28th of the previous month. *

I agree and understand
I acknowledge that I am aware that there are risks to my child of exposure to directly or indirectly arising out of, contributed to, by, or resulting from: An outbreak of any and all communicable disease, including but not limited to, the virus “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)”, which is responsible for Coronavirus Disease (COVID-19) and/or any mutation or variation thereof; In consideration of having the opportunity to participate in classes at TTP *

I agree and understand
and in acknowledging that I am aware of and willing to assume the risks associated with this activity, I hereby voluntarily agree to waive, hold harmless and indemnify To The Pointe of Performing Arts Inc. and its trustees, agents, volunteers and employees from any and all claims, demands, damages and causes of action of any nature whatsoever arising out of ordinary negligence which I, my heirs, my assigns or successors may have against them for, on account of, or by reason of participation *

I agree and understand
To The Pointe has a strict non-fraternization policy which does not allow owners, staff members, or trainees to participate in "after hours" activities such as babysitting, driving, car-pooling, tutoring, or fraternizing in any way with students under 18 years of age. Staff members who participate in these activities will be terminated. Students who participate in such activities will be asked to leave the studio. *

I agree and understand
If I do not follow the fraternization policy, I am aware that I may be asked to leave the studio due to non-compliance of TTP's Fraternization policy. *

I agree and understand
I or my child have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my or my child's participation in this activity or event. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity or event in which I may participate, and that it will govern my actions and responsibilities at said activity *

I agree and understand
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN THIS ACTIVITY OR EVENT, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I certify that I or my child is physically fit, have sufficiently prepared or trained for participation *

I agree and understand
I HEREBY WAIVE, RELEASE, AND DISCHARGE To The Pointe of Performing Arts Inc., and all divisions thereof of any and all liability and responsibility for injuries, sickness, pandemics, accidents, natural disasters and/or acts of God incurred during participation in and/or instruction of camps, intensives, private instruction, choreography or any activity I may participate. *

I agree and understand
I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this event/lessons, THE FOLLOWING ENTITIES OR PERSONS: To The Pointe of and/or their directors, officers, managers, employees, volunteers, reps, and agents. *

I agree and understand
I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this waiver, release and registration form from any and all liabilities or claims made as a result of participation in this activity or event, whether caused by the negligence of release or otherwise. The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. *

I agree and understand
I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL. Please sign below by typing Parent or Guardian's Name *
PARENT / GUARDIAN WAIVER FOR MINORS: The undersigned parent and natural guardian does hereby represent that he/she is, in fact, acting in such capacity, has consented to his/her child or ward’s participation in the activity, and has agreed individually and on behalf of the child or ward, to the terms of the accident waiver and release of liability set forth above. The undersigned parent or guardian further agrees to save and hold harmless and indemnify all parties listed. Sign below to agree *
I give permission for myself or my child to be photographed and give permission for any photos of my child to be used for advertisements, social media posts, website postings, and newsletters. (We do not post pictures with names) *
AUTO CHARGE ENROLLMENT (MANDATORY) Credit Card Number: *
Name of Card Holder *
Expiration Date: *
CVV CODE: *
Billing Address for this Card: *
Autocharge for Tuition and any deposits or any current or outstanding balances due will be taken-out using this card on the 22nd-29th of the month previous to the month the is being paid for. *

I understand and agree to the auto charge policy
I have read and agree to the Privacy Policy *