Student Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Parent or Legal Guardian's Name *

First Name

Last Name

Payment*

* I understand that all fees paid are nonrefundable and nontransferable and that tuition shall be paid at or before the first class unless other arrangements are made by written agreement with both parties. I understand that the fee for a returned check/declined card is $30. Should this provision have to be enforced by legal means, I am responsible for payment, as liquidated damages, the costs of collection, plus interest at the legal rate and reasonable attorney's fees as determined by the Court or 15% of the amount collected failing such determination. By submitting this form, I have read, understood and agree to be bound by the Payment statement above.

Liability Waiver & Acknowledgement of Risk *

I understand and agree that in participating in any dance class, workshop, rehearsal or performance, there is a possibility of physical injury or death. I voluntarily agree to assume all risks and responsibility for any such injury or accident, which might occur to me or my child during any of The Get Down classes, rehearsals, performances, or activities. I also exempt, release, and indemnify The Get Down, its owners, agents, volunteers, assistants, employees, guest artists, faculty members, and/or students from any and all liability claims, demands or causes of action whatsoever from any damage, loss, injury, or death to me, my children, or property which may arise out of or in connection with participation in any classes or activities conducted by The Get Down. I further hereby voluntarily agree to waive my rights and that of my heirs and assigns to hold The Get Down, its owners, agents, volunteers, assistants, employees, guest artists, faculty members, and/or students liable for such damage, loss, injury, or death. I understand that I should be aware of my physical limitations and agree not to exceed them. If I am agreeing to this waiver for my children, I certify that I am the parent or legal guardian and have the right to waive these rights. I also give full permission to The Get Down to use photographs of students for publicity purposes. By submitting this form, I have read, understood and agree to be bound by the Liability Waiver & Acknowledgement statement above.

Agreement *

By submitting this form, I have read, understood and agree that all information provided above to be true and to be bound by the above statements.