SAAM - South Asian Arts Movement: Registration Form

TERM 2

Why Register online: It is convenient and you get an instant receipt. Reduces administration and delays in processing. Due to COVID-19 we are only accepting monthly Pre-authorized Credit Card payments. Your payment will be processed using the SECURE encrypted business Merchant Terminal under the business name 'The Balance Code & Yoga Ltd.'

SECTION A: CLIENT INFORMATION

First name of participant/student: *

Last name of participant/student: *

Date of Birth (dd/mm/yyyy) *

Date

Parent Name (Complete if participant is under 18 years of age. Type "NA" if not applicable): *

Primary Email Address: *

Home Phone: *

Mobile Phone: *

Home Address: *

City: *

Postal Code: *

Please note: Email is our primary method of communication with you. By providing your email address you give us consent to communicate with you via email.

SECTION B: DANCE CLASS INFORMATION (please be sure to check the days/timings on our website before registering!)

What class(es) are you registering for? (Choose all the classes the participant would like to register in): *

Kids Bollywood Dance Youth/Teen/Young Adult Bollywood Dance Adult Recreational Bollywood Dance Beginner Kathak Level 1 Kids Kathak Level 2 Other

SECTION C: COSTUME DEPOSIT TERMS & CONDITIONS: We require a costume deposit for ALL performing arts students each year. PLEASE BE SURE TO SELECT YOUR COSTUME BELOW IN THE FEES SECTION. We currently only accepting Costume Deposits for Term 2 registrations.

A $60 non-refundable costume deposit for EACH registered program/class type will be collected (except for Recreational Adult classes & Bharatanatayam classes). Some elaborate costumes, including Classical dance costumes, may cost more than $60. For costume requirements in excess of the $60 deposit collected, the participant and/or his/her parents hereby acknowledge responsibility to pay the excess. Students/Parents agree that they may or may not be informed of the costume costs in advance; costume design is part of the choreographer"s overall artistic plan for dance performances. Any participants who do not provide a costume deposit at the time of registration, may still attend classes, but will not be allowed to perform at any occasion and will be excluded from regular formation-based choreography. *

I agree to the Costume Deposit Terms & Conditions.

ALL CLIENTS PLEASE READ SECTION D BELOW AND TYPE YOUR SIGNATURE IN THE BOX.

SECTION D: WAIVER ALL PARTICIPANTS - Liability Wavier; please read carefully. Glossary: "Club/Studio" refers to South Asian Arts Movement Society, The Balance Code Yoga & Wellness Ltd. Assumption of Risk of Injury and Wavier of Claims: I assume all risks of injury and waive all rights to pursue money damages or any other relief of any kind as a result of anything occurring at or near the Club/Studio location or any other venue used by the Club/Studio or its employees, officers, directors or other representatives (including but not limited to dance and/or fitness instructors and/or personal trainers and/or artists managed by the Club/Studio and/or contractors of any type). In the event I am injured while on a property the Club/Studio uses to conduct classes, performances, or workshops, I will hold harmless the Club/Studio and all of its owners, shareholders, directors, volunteers, sub-contractors, employees, agents, representatives, successors and assigns from all claims of any sort for damages or relief, including but not limited to claims for contribution. I acknowledge there is possible danger connected with any physical activity (including the dangers of physical injury and death) and knowingly and voluntarily waive my right to make a legal or equitable claim of any sort against the Club/Studio and all of its owners, shareholders, directors, volunteers, sub-contractors, employees, agents, representatives, successors and assigns from all claims of any sort for damages or for other relief, including but not limited to claims for contribution. This assumption of risk and wavier of liability applies to my family members, successors, heirs, and assigns. Physical Condition and No Medical Advice: I represent that I am in good physical condition and have no medical reason or impairment that might prevent me from my participation or intended use of the Club/Studio and the services offered. I acknowledge that the Club/Studio and all of its owners, shareholders, directors, volunteers, sub-contractors, employees, agents, representatives, successors and assigns will not and cannot provide me medical advice relating to my physical condition and ability to use the facilities/participate in programs/classes. If I have any health or medical concerns now or after joining a class, I will discuss them with my doctor before attending & participating in any classes or using the Club/Studio"s services. Death/Disability Clause: If I die or become totally or permanently disabled, upon reasonable written notice to the Studio/Club Owner of the death or disability, either I or my estate may cancel this agreement and receive a pro-rata refund for my unused sessions/classes. Cancellation and Refund: To cancel this agreement, the client must notify the Club/Studio Management in writing. A refund of unused classes, MINUS a 15% administrative charge, can be provided upon withdrawal from any dance term EXCEPT in the cases where the fees paid or program purchased were purchased on sale or discounted - in this case all fee are FINAL SALE - no refunds will be issued I, the undersigned, waive and release the Club/Studio and its owners, shareholders, directors, volunteers, sub-contractors, employees, agents, representatives, successors and assigns from any and all claims in any way connected with my participation. This agreement is binding on my heirs and executors. I understand that ALL aspects of this wavier apply to any children that I bring with me to any of the classes/programs/events/meetings or gatherings offered by Club/Studio. I acknowledge that I am the legal guardian of the child(ren) listed on this form (if any). By signing this document, I acknowledge that I have read or heard this document in its entirety and that I fully understand it. I have asked any questions that may have occurred to me and have been answered to my satisfaction. A legal guardian/parent must sign for any participants under the age of 18 years. Your typed signature below will be considered identical to your actual signature if this form is submitted electronically. *

Date Signed: *

Date

ALL CLIENTS, PLEASE NOTE: The studio does not provide make-up classes for ANY registered programs.

Would you consider volunteering for SAAM on any of our committees?

AFTER YOU HIT 'SUBMIT' YOU'LL BE REDIRECTED TO THE SECURE PAYMENT PAGE. You will be charged your first month fee and automatically enrolled in our monthly PAC recurring plan. All monthly fees are non-refundable. All costume deposits are non-refundable.

SECTION H: Please provide your consent to allow SAAM to use photos/video taken in class and at performances, that may have you/your child in them, for SAAM"s promotional and advertising purposes. *

Yes, I provide my consent. No, I do not provide consent.

I was referred to SAAM by: