SPRING 2024 5 Week Registration Form
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Email *
Dancers Name *
Dancers Birth date *
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Parent/ Guardian name *
Address *
Best Phone Number *
In case of emergency notify: (please add phone number) *
Dance Experience *
5 Week class registering for: *
LIABILITY WAIVERThe student enrolling in Miss Jessica’s JAMZ Studio of Dance, Inc. or parent/legal guardian of student if under 18 years of age, understands and agrees that while participating in any dance class there is the possibility and potential of physical injury. The enrolling student or parent/legal guardian, agrees therefore, to assume all risk of any such injury which may occur during any and all of Miss Jessica’s JAMZ Studio of Dance, Inc. classes. Students and/or parent/legal guardian, exempts, releases, and indemnifies Miss Jessica’s JAMZ Studio of Dance Inc, its owners, faculty members, guest artists, landlord etc. from any and all liability claims, demands, or cause of action whatsoever from any damage, loss, or injury to student, parent/legal guardian, family member or personal property which may arise out of, or in connection with participation in any activities conducted by Miss Jessica’s JAMZ, Studio of Dance, Inc.Throughout the year we take photos and video of our students which could be used in our print or internet advertising, on our websites, for inclusion in our scrapbooks, for recital programs, or other uses related to our studio. We also have professional photographers for some events. May we have permission to use and publish images of your student?Please initial: Yes_______ No_______COVID ADDENDUM TO LIABILITY AND HOLD HARMLESS WAIVERI acknowledge, that in the middle of a global pandemic, there is serious risk that by attending in person classes and being at the facility of Miss Jessica’s JAMZ Studio of Dance, Inc., I or my children can contract a dangerous virus or other health condition, and that I accept this risk and nonetheless voluntarily choose to allow my children at attend classes at the facility. In consideration of my children being allowed attendance in class during the COVID-19 pandemic and any other global pandemic going forward, and for other good and valuable consideration, receipt of which is hereby acknowledged, on behalf of myself, my children and all others who may claim by, under or through myself I do hereby agree to indemnify and hold harmless and do hereby exempts, releases, indemnifies and holds harmless forever Miss Jessica’s JAMZ Studio of Dance, Inc and all of its officers, employees, guest teachers, agents and assigns an all other persons or companies from any and all claims , actions or causes of action which I or my child may now have or which may thereafter accrue, whether for personal injury or property damage, whether known or unknown, arising out of or in anyway resulting from my and/or my children’s in person attendance in Miss Jessica’s JAMZ Studio of Dance, Inc. during the COVID-19 pandemic and any other global pandemic going forward.By signing below, I agree that I have read, understand and agree with the terms of this waiver. This document must be signed for the dancer to enter the classroom.Student name (print)_________________________________ Parent/Guardian name (print)__________________________________ Parent/Guardian signature (sign)__________________________________ Date __________________________________ *
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