Student Name
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First Name
Last Name
Student Date of Birth
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MM
DD
YYYY
Email
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Phone Number
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(###)
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Zip Code
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What class(es) would you like to sign up for?
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Please include the DAY, TIME, CLASS, and INSTRUCTOR.
Not sure what class to enroll in?
Click here to view our Summer Session 1 schedule here!
Registration
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New to EDS and looking to try a class first?
Click here to sign up for a trial class today!
Liability Form
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In consideration of being allowed to participate at any Elements Dance Space class or event,
I, for myself, and on behalf of my heirs, assigns, personal representative, and next of kin,
the undersigned:
1. Release, waive, discharge, and agree not to file suit against Elements Dance Space , their
affiliated clubs, their administrators, directors, agents, coaches, and other employees of the
organization, other participants, volunteers, sponsoring agencies, sponsors, advertisers,
their heirs, and if applicable, owners and leasers of premises used to conduct the event, all
of which are hereinafter referred to as "releasees", from demands, losses, or damages, on
account on injury, including death or damage to property, caused or alleged to be caused in
whole or in part by the negligence of the releasee or otherwise.
2. Assume all the foregoing risks and accept personal responsibility for the damages
following such injury, permanent disability, or death.
3. Authorize and give my full consent to Elements Dance Space to copyright and/or publish
any and all photographs, videotapes, and/or film in which I and/or the minor participants
appear while attending any Elements Dance Space class or event. I further agree that
Elements Dance Space may transfer, use, or cause to be used, these photographs,
videotapes, or films for any exhibitions, public displays, publications, commercials, art and
advertising purposes, and television programs without limitations or reservations.
4. Certify that I do consent and agree to my release as provided above of the releasees, and
for myself, my heirs, assigns, and next of kin, to indemnify and hold harmless the releasees
from any and all liabilities incident to my involvement or participation in these events as
provided above. I hereby agree that I am signing this registration form with or without
my parent/guardian present.
5. I am aware of and understand the autopay and cancellation policy that reads: If you wish
to drop a class from your schedule (or all classes completely), you must see the front desk
to complete a drop form. This form must be submitted two weeks prior to the next billing
date. Your enrollment continues until this form is completed. There are no refunds given.
6. I am aware of and understand the tuition policy that reads: Tuition, as well as any
outstanding balance will be withdrawn from your card on file on the last day of each month
for the proceeding month. (For example: Tuition for August will be due on July 31st.)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to my release as assigns, provided above of the releasees, and for myself, my heirs, and next of kin, to indemnify and hold harmless the releasees from any
and all liabilities incident to my minor child's involvement or participation in these events as provided above.
COVID-19 Liability Form
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Our goal is to provide a safe environment for our clients and staff. This document provides information we ask you to acknowledge and understand regarding the COVID-19 virus.
The COVID-19 virus is a serious and highly contagious disease. The World Health Organization has classified it as a pandemic. You could contract COVID-19 from a variety of sources. Our studio wants to ensure you are aware of the additional risks contracting COVID-19 associated with being in the studio.
The COVID-19 virus has a long incubation period. You may have the virus and not show symptoms and yet still be highly contagious. Determining who is infected by COVID-19 is challenging and complicated due to limited availability for virus testing.
Due to the frequency and timing of visits in the studio, characteristics of the virus, and the characteristics of how classes may be held, there is an elevated risk of you contracting the virus simply by being in the studio. In addition, if you are traveling out of state during this time, we ask that you notify us via email at least 48 hours in advance before entering our doors to help keep all of our clients safe and healthy as best as possible. We may ask you to stay at home to quarantine after your trip.
By signing this agreement, I hereby acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to, or infected by COVID-19 by entering Elements Dance Space and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at Elements Dance Space may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Elements Dance Space management, employees, volunteers, and other clients. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury, illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at Elements Dance Space, or participation in classes.
I hereby release, covenant not to sue, discharge, and hold harmless Elements Dance Space, as well as all employees, agents, and representatives, of and from all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of Elements Dance Space, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after attending in any Elements Dance Space classes or lessons.
Parent/Legal Guardian Signature
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First Name
Last Name
