June 12 Sign-up Form—Feel Good Music Series—FREE Dance/Movement Workshops

Sign-up Form

Dance/Movement Workshops—Saturday, June 12, 2021
(Porfavor de dirigirse a la esquina derecha arriva de este documento para cambiar el idioma)
Please use this form to register for FREE dance/movement workshops offered in conjunction with the kickoff day of the Feel Good Music Series on June 12, 2021, at Charles Point Park, Peekskill, NY.

Parents, please fill out a separate form for yourself if you plan to participate in the 10 AM adult yoga class.

All participants must be masked and follow NYS health and safety protocols in order to participate.

Participants should attend in comfortable sports attire and athletic footwear.

Please note that this is not a drop-off event. Parents must remain present in the park during the workshops. Children must be supervised at all times.

Please arrive at least 15 minutes before workshop start time.
Name of participant: *

First Name Last Name
Participant's age (if a child)
Contact cell phone: *
Contact email: *
example@example.com
The above named person will participate in the following workshops:

Creative Movement/Ballet (ages 2-7 with parent/s) 10:00 am - 10:30 am Yoga (Adults) 10:00 am - 10:30 am Hip Hop (ages 8-18) 1:30 pm - 1:55 pm Ballet (ages 8-18) 1:55 pm - 2:20 pm
LIABILITY WAIVER AGREEMENT
I hereby agree to the following:

That I/my child participating in the movement class(es) organized by Arts 10566 in conjunction with the Feel Good Music Series. I recognize that the activities require physical exertion and I am fully aware of the risks and hazards involved.

I represent and warrant that I/my child am/is physically fit and I/my child have/has no medical condition, which would prevent my/my child's participation in these classes.

I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating.

In further consideration of being permitted/my child being permitted to participate in the classes on June 12, I knowingly, voluntarily and expressly waive any claim I may have against Arts 10566 or any parties associated with the running of the Feel Good Music Series dance/movement classes for injury or damages that I or my child may sustain as a result of participating in these classes.

I hereby take full and sole responsibility for any liability of loss or damage to personal property associated with my or my child's participation in these classes.

I, my heirs or legal representatives forever release, waive, discharge and covenant not to sue Arts 10566 or its associates for any injury caused by their negligence or other acts.

I have read the above release and waiver of liability and fully understand its contents.

Upon booking participation in any of the June 12 Feel Good Music Series dance/movement workshops I voluntarily agree to the terms and conditions stated above under my own free will.
*

I have read the Liability Waiver Agreement and agree to its terms.
Name *

First Name Last Name
Signature *

Clear
Date *

Month Day Year
Date
Do you consent to us contacting you? *

I accept. I do not accept.
Signature *

Clear
Should be Empty:

Sign-up Form

LIABILITY WAIVER AGREEMENT