JUMP 3.0 Student Enrollment Form

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J.U.M.P.- J.ust U. M.ove P.roductions aspire with Quality and over 30 years of experience; to Inspire, Empower, and Equip, while offering innovative opportunities within Creative Arts, Performing Arts, and Productions for those who wish to Venture into the World of Artistic Expression!

>FOR AGES 4 to Adult, we offer:

• Collaborations of Contemporary Ballet, Modern/Lyrical, Hip-Hop/Cultural, Jazz/Musical Theater, Liturgical /Creative Movement, Dance Fitness/Zumba for our specialized Dance styles

• Performance opportunities as JUMP 3.0 Dance members and Dance performance team at our Community Sporting events, Festivals, Parades, Holiday events and programs, including special events.

• Professional and Technical training via our Group Dance sessions and Dance Intensive Clinics during the Winter and Spring seasons.

JUMP 3.0 also sponsors and hosts Annual Dance Showcases, Dance Conventions, and Dance Competitions.

** JUMP 3.0 is an official Creative and Performing Arts Production Agency are willing to groom our Members into becoming the absolute shinning stars you were created to be! If you are seeking professional guidance with becoming a professional dancer within the entertainment industry, please email j.u.m.productions with your request.**
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Welcome to JUMP!J.ust U. M.ove P.roductions How did you hear about us?
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Member Name* This field is required.
First Name
Last Name
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Date of Birth* This field is required.Member
Date
Year
Month
Day
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Parent/Guardian Name* This field is required.
First Name
Last Name
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Email* This field is required.
example@example.com
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Phone Number* This field is required.
Area Code
Phone Number
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Do you have transportation?
YESNO
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What school or church do you attend?Regarding the Member
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What Category of Service are you Interested in?* This field is required.Please select which Category of Service you are most interested.
VIRTUAL PRIVATE LESSONS
VIRTUAL DANCE AND FITNESS CAMPS
VIRTUAL GROUP LESSONS
VIRTUAL CREATIVE ARTS WORKSHOP/CLINIC
VIRTUAL SPECIALTY CLASS INSTRUCTOR FEATURE
VIRTUAL AFTER SCHOOL PROGRAM
IN- PERSON PRIVATE LESSONS
IN- PERSON DANCE AND FITNESS CAMPS
IN- PERSON GROUP SESSION
IN- PERSON CREATIVE ARTS WORKSHOP/CLINIC
IN-PERSON SPECIALTY CLASS INSTRUCTOR FEATURE
IN- PERSON AFTER SCHOOL PROGRAM
DANCE SHOWCASE/CONFERENCE/CONVENTION
Other
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The Art of Expression through Movement is such a magnificent masterpiece with so many dynamics to experience... Start TODAY! LIVE.LAUGH.LOVE MORE.DANCE.

Come and Explore the Wonders of Innovation, Expression, and Movement with J.U.M.P.!
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What Style/Genre of Dance are you most interested?There are several genres of Dance that we teach that may not be listed, so please inquire with “Other” If not included on list.
BALLET (Classical and Contemporary)
MODERN (Contemporary and Lyrical)
JAZZ (Contemporary)
HIP-HOP
AFRICAN
LATIN
LITURGICAL DANCE
DANCE FITNESS aka JUMP FITT
CULTURAL
STEP
ZUMBA
CREATIVE MOVEMENT
Other
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What Age are You or Person of Interest?* This field is required.
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Do you have any previous Dance training? If so, provide a brief summary.If not, No worries. NO EXPERIENCE REQUIRED.
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What’s your Reason for taking Dance sessions?
Just for Fun!
Professional Dance Training
Performance Opportunities
Dance Team sounds exciting
Want to become a professional dancer
Community
Preparing for AUDITION, SHOWCASE, COMPETITION
Special Occasion
Mental/Behavioral Wellbeing
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What is Member’s Favorite Color?
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What are Member sizes?Top, Bottom, Dress, Shoe
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What are your Top 3 FAVS?Member Hobbies, Outings, Treats, etc.
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Small
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Ok
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J.U.M.P. 3.0 welcomes you to our Dance Community! By registering today, you have earned Membership into our Family; as this allows you access to join our Dance sessions, eligibility for Dance Team, and qualifies you for VIP ACCESS to our future events and entertainment opportunities.

Here, we have provided our Investment Chart for you to make your selections.

• REGISTRATION:

> $5 for JUMP 3.0 DANCE MEMBERSHIP REGISTRATION

> $10 for DANCE TEAM REGISTRATION

> $65 for DANCE TEAM ENROLLMENT

• IN PERSON DANCE/FITNESS SESSION:

> (2) SESSIONS @ $10 per month - YOUTH

> (4) SESSIONS @ $20 per month - YOUTH

> (2) SESSIONS @ $20 per month - ADULT

> (4) SESSIONS @ $30 per month - ADULT

> UNLIMITED SESSIONS @ $30 per month - ALL AGES

• UNIFORMS:

> $55 - INCLUDES JUMP 3.0 Training Attire and Dance shoes

In addition, J.U.M.P. 3.0 Offers:

• 6 WEEK Packages* for VIRTUAL AND IN-PERSON PRIVATE LESSONS and VIRTUAL GROUP SESSIONS: ENTER AMOUNT IN "CUSTOM VALUE BOX"

30 mins starting @$15-$25 USD

60 mins starting @$20-$40hr USD

• VIRTUAL AND IN-PERSON DANCE AND FITNESS CAMP SESSIONS:

PER WEEK starting @$100 - $150 USD

• DANCE CLINIC/WORKSHOP: ENTER AMOUNT IN "CUSTOM VALUE BOX"

> $25 per event

> $50 per showcase

• YOUTH HEALTHY AND TASTY NUTRITION PACKAGE: ENTER AMOUNT IN "CUSTOM VALUE BOX"

> $35 (includes kid friendly, plant-based, gluten-free Protein shakes, all natural Vitamins & Energy Boosters)

All other services will receive our best Quote upon request.
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When would you like to StartPlease specify Date Below
Date
Year
Month
Day
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BELOW YOU WILL FIND OUR INVESTMENT CENTER, as we believe in making good investments into our gifts, talents, and overall health and well being.
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J.U.M.P.* This field is required.Investment Center ALL SERVICES ARE PRE-PAID. Amounts are based on One Time Rate for Monthly Dance Sessions, Private Lesson Rate (USD) x 6 WEEKS for Package, and Camp & Convention Rates.
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55.00
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65.00
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Investment
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+ OR enter a custom value
Credit Card
First Name
Last Name
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Signature* This field is required.
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All payments must be due prior to class participation; Monthly students every 1st SATURDAY of the Month by 12noon.

No Refunds, only Credits we will honor! Upon a doctor’s written request, we will offer a 50% refund on pre-paid services, if you will have to withdraw from the program due to Medical reasons only. (request withdrawal info for further details).
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Code of Ethics: I agree that my child or I will be accountable to the standards of attendance, dress code, and participation, as I understand that J.U.M.P. 3.0 only requires dedication and passion to succeed from its students. I understand that it is my responsibility to remain respectful and committed towards showing up on time for class and payments, as we both work together for the betterment of all participants.
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Signature* This field is required.
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Liability Waiver and Insurance

LIABILITY WAIVER

Safety is the main objective here at J.U.M.P. 3.0, as classes offered are of physical nature and include the risk of physical injury either from oneself or another participant or in the use of facilities. Any activity involving motion has a chance of accidental injury. I, hereby accept all risks associated with participation and understand that there are possibilities of physical injury. I, the undersigned parent and/or legal guardian of the student listed above, do hereby give permission for the aforementioned persons to participate in any and all classes, programs, recitals, shows and events offered by or attended by J.U.M.P. 3.0. I, hereby covenant not to sue and waive, release, and forever discharge any and all rights and claims for any physical injury or damages; loss of items stolen in or on our property, which may arise now or in the future against J.U.M.P. 3.0 and its officers, owners, directors, employees, the owner of facility in which J.U.M.P. exist and/or other assigned representatives or volunteers from any and all liability and for any and all damages and/or injuries which may be sustained or suffered by the student listed above while participating at or for J.U.M.P. 3.0. Furthermore, I hereby give my permission to J.U.M.P. 3.0 to use photographs and/or videos of the student listed above as deemed appropriate for the marketing, promotion, and advertisement on J.U.M.P. 3.0 via social media/networking, website, etc.
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Signature* This field is required.
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INSURANCE

J.U.M.P. 3.0 does not carry medical insurance for its students. It is required that all students be covered by their own family or state insurance policy and it is understood that if injury does occur, the students own insurance policy is the only source of compensation and/or reimbursement. My signature below, indicates my certification that I have medical insurance on the student listed above and will maintain coverage while he/she dances at J.U.M.P. 3.0. I also authorize J.U.M.P. 3.0 and its owners, employees, directors, etc. to use standard first aid procedures on the student listed above and consent to any other medical transport and/or authorized procedures that is deemed necessary in the case of an emergency.
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Do you have Medical Insurance?* This field is required.Please indicate Below
YESNO
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Medical Insurance CarrierPlease provide important information for in case of an emergency
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Medical Insurance Member NumberPlease provide in case of an emergency
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Signature* This field is required.
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EMERGENCY CONTACT 1First and Last Name
First Name
Last Name
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RelationshipPlease specify for safety reasons
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Phone Number
Area Code
Phone Number
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EMERGENCY CONTACT 2First and Last Name
First Name
Last Name
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RelationshipPlease specify for safety reasons
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Phone Number
Area Code
Phone Number
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Non- Disclosure Agreement

J.U.M.P. 3.0 agrees that in consideration for access to student and/or participant(s) information submitted to J.U.M.P. 3.0 by (client of the disclosing), we will keep all information provided and relating to personal and private information secure and in strict confidence. J.U.M.P. 3.0 will only disclose information, if necessary in a medical emergency circumstance, and/or solely to individuals who have signed Non-Disclosure Agreement or who have been authorized from the client, either by verbal or written agreements, in order to receive information by the undersigned. This is well understood and secure agreed upon this day.
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Signature* This field is required.
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CONSENT SIGNATURE:

My signature below indicates that I have read, understand, and will abide by all general policies and regulations that are set forth by J.U.M.P. 3.0 and its owners, employees, and directors and any additional policies or requirements as set forth throughout the year.
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Signature* This field is required.
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Take Photo of New MemberThis is for security reasons and publishing your Member Card
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Thank you so much for completing and submitting your JUMP 3.0 Dance Student Enrollment Form. We appreciate your investments towards this fun and life changing experience for you or your child. You will receive a follow up Welcome Letter and Link for our upcoming Student/Parent Virtual or Conference Call, where we will provide you with all necessary information and details needed in order for us to best support you. We are super excited to Dance with you!
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