Summer Registration Form

Summer Registration Form

Fill out the form carefully to finalize registration - once this form is submitted you will be sent an invoice for a $50 non-refundable deposit that will hold your dancers spot in camp. One week before camp an invoice with the remainder of the fees will be sent along with a welcome letter of what to expect and bring. Camp must be paid for on or before the first day. For your convenience there will be a staff member in the office each Monday morning of camp to process unpaid payments on site(debit, credit, or cash).
Jr Dance Camps: $185 + gst

Mini Dance Camps: $135 + gst

Go Getter Dance Camp: $199 + gst

Summer Intensive: $320 + gst
First Student Name*

First NameLast Name
Second Student Name

First NameLast Name
Third Student Name

First NameLast Name
Parent 1 or Guardian Name *

First NameLast Name
Parent 2 or Guardian Name

First NameLast Name
First Child Birth Date*

MonthDayYear
Second Child Birth Date

MonthDayYear
Third Child Birth Date

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent E-mail*
example@example.com
Parent Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name *

First NameLast Name
Emergency Contact Phone *
Please enter a valid phone number.Format: (000) 000-0000.
Camps Student 1*
Camps Student 2
Camps Student 3
Allergies / Special Considerations
EXPRESS ASSUMPTION OF RISK AND RELEASE OF LIABILITY
To: Shuswap Dance Center ("the Company") and its directors, officers, employees, representatives and agents (collectively called "the Agents").
1. I agree as a precondition to my participation in all events organized by "the company" and/or"the Agents" including, but not limited to: Dance classes, events & shows (Collectively referred to as "the Activities") and in further consideration of "the Company" allowing me to do so, that I will be strictly bound by the terms of this Release of Liability, Waiver of Claims, Assumption of Risk and Indemnity Agreement.
2. | acknowledge that "the Activities" involve inherent risks and dangers that may cause serious injury and possible death to participants.
3. I fully understand the risk and dangers associated with my participation in "the Activities" and accept same entirely at my own risk.
4. | hereby waive any and all claims which I may have against "the company" and "the Agents" and release "the Company" and "the Agents" from all liability for injury, death, property damage of any other loss sustained by me as a result of my participation in "the Activities", due to any cause whatsoever: including negligence, breach ofcontract, or breach of any statutory or other duty of care by "the Company" and/or the Agents".
5. I appreciate that "the Agreement" limits the liability of "the Agents" to the same extent as it limits the liability of "the Company", even though "the Agents" are not formalparties to "the Agreement".
6.. I will not hold the studio, faculty, staff, students or their families responsible for any sickness or viruses contracted while participating in classes or while visiting the studio.
7. I agree that while participating in virtual classes at home ,the Studio Directors, faculty and staff will not be held responsible for any property damage or injury incurred while taking these said lessons.
I AM 16 YEARS OF AGE OR OLDER, AND I HAVE READ AND UNDERSTAND "THE AGREEMENT". | UNDERSTAND THAT THIS DOCUMENT CONTAINS A PROMISE NOT TO SUE "THE COMPANY "AND/OR "THE AGENTS" AND THAT IT CONSTITUTES A RELEASE OF LIABILITY AND AN INDEMNITY FOR ALL CLAIMS. IF I AM THE PARENT AND/OR GUARDIAN OF THE PARTICIPANT I HAVE READ AND UNDERSTAND AND EXECUTE "THE AGREEMENT" ON BEHALF OF THE CHILD/WARD.
Please note that by signing this agreement, you give up the right to sue for any injury or damages, howsoever caused.
I hereby sign this agreement on behalf of myself, my personal representatives, heirs and assigns:
I authorize my child Student(s) name(s) * to have their photo/video taken. I authorize it to be used for promotional use(on the internet/newspaper etc).
Signature*

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