INFORMED CONSENT AND WAIVER OF LIABILITY
I HAVE ENROLLED MY CHILD IN A PROGRAM OF PHYSICAL ACTIVITY INCLUDING, BUT NOT LIMITED TO, DANCE,MOVEMENT, EXERCISE, TUMBLING AND BASIC MOTOR SKILLS (JUMPING,HOPPING,GALLOPING, SKIPPING, RUNNING). I UNDERSTAND THE INHERENT RISKS, INCLUDING INJURY, THAT MAY RESULT IN MY CHILD’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’S ENTRY IN ACTIVITIES SPONSORED BY A 5-6-7-8 DANCE CO. I HEREBY AFFIRM THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE INFORMATION. I UNDERSTAND THAT PARTICIPATION INCLUDES POSSIBLE EXPOSURE TO AND ILLNESS FROM INFECTIOUS DISEASES INCLUDING, BUT NOT LIMITED TO COVID-19. WHILE PARTICULAR RULES AND PERSONAL DISCIPLINE MAY REDUCE THIS RISK, THE RISK OF SERIOUS ILLNESS AND DEATH DOES EXIST. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISK RELATED TO ILLNESS AND INFECTIOUS DISEASES, SUCH AS COVID-19, EVEN IF ARISING FROM THE NEGLIGENCE OR FAULT OF THE RELEASED PARTIES.
IN ADDITION TO THE ABOVE, I GIVE MY PERMISSION TO ALLOW A 5-6-7-8 DANCE CO. STAFF TO PHOTOGRAPH AND /OR VIDEOTAPE MY CHILD(REN) DURING A 5-6-7-8 DANCE CO. EVENTS FOR THE PUPOSES OF PROMOTING A 5-6-7-8 CO. AND / OR TEACHER TRAINING. I ALSO UNDERSTAND THAT MY CHILD WILL BE SENT HOME AND WILL NOT PARTICIPATE IN ANY CLASS UNTIL DELINQUENT ACCOUNTS ARE PAID IN FULL!
I understand A 5-6-7-8 Dance Co.’s payment process and agree to allow A 5-6-7-8 Dance Company to charge my debit/credit card the amount of my child’s tuition on the 22nd of each month from August 2022 through August 2023. I understand that when canceling automatic payment, I must bring to A 5-6-7-8 Dance Co. a written copy of automatic payment cancelation.