Creative Movement

School of Dance

(603)298-5700

Name                     ________________________________________________________

Phone                     ________________________________________________________

Address                 _______________________________________________________

                                _______________________________________________________

Date of Birth          ____________________________ Age_______________________

Contact                  ____________________________ Phone _____________________

Email                      ________________________________________________________

I, the undersigned, am the guardian of the above named.  I am aware of the physical demands of dancing.   I understand that if, at anytime, my dancer does not feel comfortable executing a step, she or he should ask for extra assistance, or for the step to be modified.  My dancer also understands that, at no time, should she or he be doing anything in class that has not been taught to him or her by the instructor. (In example...gymnastics)  Keeping the physical risks in mind, I agree that I will not hold the teachers, choreographers, student teachers or  student choreographers at Creative Movement School of Dance accountable for any injury that may occur while my dancer is learning to dance.

Signed ______________________________________________Date_________

In registering my dancer for class at Creative Movement School of Dance, I agree that the registration is non-refundable, under any circumstance.  I understand that if I do not pay for class and the showcase charge by the deadline date, I will not be able to perform in the showcase.  I understand that there is no refund for costumes regardless of whether I decide to perform.

Signed ______________________________________________Date_________

Should I be paying on a credit card, I am aware that I am responsible for all of the payments as though I had paid up front and that all of the above agreements apply to me, regardless of the number of classes I choose to attend.

Signed ______________________________________________Date________

NO REFUNDS

Last modified: 11/18/09