Choreography Contract

Form
Client Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState

Zip Code
Venue Name & Address:
Event Date & Invitation Time

MonthDayYear
Date
Hour MinutesAM/PM Option
Type of Event
Are you interested in Master of Ceremony Service? ($450 extra)
$75 discount for choreography package.
Name of Start: Quinceañera or Bride & Groom.
Quinceanera's Name or Future Bride & Groom, Etc
Account Information
Balance due must be paid 7 days before the event. In case of cancellation, the deposit and amount paid-to-date are non-refundable.

Payable to: Yajaira DeJesus-Rodriguez
Client Signature

Liability Waiver

I, (parent/adult), hereby permit my child/student & court (“Group”), to rehearse choreography for the event at YR Dance & Events (the “Program”). The Group participation includes activities in any studio/venue where the group rehearses or performs as well as transit and other ancillary group activities provided by the Program. I agree that to participate in the Program, I, my child & court will be required to observe program policies and standards of conduct. I will instruct my child to comply with the Program’s policies and standards of conduct, both those that may be provided in writing at the commencement of the Program and those that may be issued, orally or in writing, from time to time at the discretion of the instructor. I agree that the Program has the right to enforce its standards of behavior and may terminate the Group participation in the Program for any conduct that the Program considers to be incompatible with the interests, comfort, and welfare of the instructor or the other children participating in the Program. I acknowledge that the Group participation in the Program may involve risk of personal injury. I hereby certify that I understand the nature and extent of the risks inherent in the Program, and the use of facilities, equipment, or services in association with the Program. On behalf of myself and my child, I hereby assume all risks related to participation in the Program, including but not limited to accident, death, injury, or illness, including personal or bodily or mental injury of any nature. I further hereby, on behalf of myself, my child and anyone claiming through myself or my child, do FOREVER RELEASE the Program, its directors, officers, employees, volunteers, students, agents, and assigns from any cause of action, claims, or demands of any nature whatsoever, including but not limited to a claim of negligence which I, my child, Group, or anyone claiming through myself or my child, may now or in the future have against the Program on account of personal injury, bodily injury, property damage, death or accident of any kind, arising out of or in any way related to my child’s participation in the Program howsoever the injury is caused.

I understand that this Program is not a medical or healthcare program. I do not expect any medical or health benefit to my child & court from participation in the Program.
I fully understand and acknowledge that I am responsible for any damage that I or my child, or court cause to any facilities or equipment used by the Program. I understand that the Program will notify me in writing of the cost to repair any damage, and I agree to pay the cost to repair the damage within thirty days of such written notice.
I certify that my child is medically able to participate in the Program and is free from any communicable, infectious, or contagious diseases.
IN CASE OF EMERGENCY such as accident or injury, I give permission to the Program to provide assistance to procure emergency medical care in the event that I or person(s) I designate on this form cannot be reached.
Parent's Name

First NameLast Name
Relationship to Student/Child
Today's Date

MonthDayYear
Date
Signature
I give permission to use, reprint, and produce any photographs or videos taken of me, my child, and/or my group. I understand that such material may be used by the Program for promotion. Material can be used on our website and social media.
Signature
Should be Empty:

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