Waiver Release Form

Dancer Name*

First NameLast Name

Dancer Date of Birth*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Contact Number*

Please enter a valid phone number.

Parent/Guardian Email*

example@example.com

Parent/Guardian Name

First NameLast Name

Parent/Guardian Contact Number

Please enter a valid phone number.

Parent/Guardian Email

example@example.com

Dancer Allergies or Health/Medical Concerns

Medications (only if they are coming with the dancer to the studio ex: Epipen, Puffer)

Assumption of the Risk and Waiver of Liability

Despite precautions, accidents and injuries may occur. By registering for classes and paying the class fees, you agree to be bound by this waiver. I/we (the dancer and/or parent/guardian) assume all risks related to participation in The Rosemary Breman School of Dance’s dance and fitness classes. I/we agree to release and hold harmless The Rosemary Breman School of Dance including its teachers, dancers, staff members, and facilities used by the studio from any cause of action, claims, or demands now and in the future. I/we do not hold The Rosemary Breman School of Dance liable for any personal injury or any personal property damage as a result of participating in dance and fitness classes. Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behaviour in addition to any damage I/we may cause to any property utilized by myself/my dancer during dance and fitness classes. I/we agree that cancellations may occur due to lack of enrollment in scheduled classes.

Photo Waiver & Social Media Rules:

1. Classroom and recital photos will at times be used in our own promotional material. Please inform your child’s teacher if you wish to have your child’s name added to our “no photo” list.

2. Students who post photos/videos of themselves on social media may do so but any photo taken at our studios may only be posted with the approval of all students and teachers in the photos/videos.

Dress Code:
-I have read and will abide by my child’s dress code.
-I understand that the dress code must be adhered to in Zoom classes as well as in the studio.
-I understand that teachers may ask students to sit out if they are not wearing the proper dance attire, shoes, and hair for their dance class.

Fees, amendments & other:

1.     I understand that any classes held in studio may be switched to an online format if the Government of Ontario places restrictions on businesses. This is up to the discretion of the director of The Rosemary Breman School of Dance. No refunds or discounts will be given if classes are able to continue via Zoom or any online video conferencing platform.
2.     I understand that The Rosemary Breman School of Dance does not give credit and/or refunds for class(es) missed due to holiday, vacation, illness, weather, internet connection issues, and any other situations whereby a parent/dancer are unable to bring their child to class.
3.     Refunds will only be given up to the end of the second week of the semester. After this period there will be NO refunds.
4.     I understand that there will be a $40 NSF fee due should a payment be returned by the bank.

By signing this waiver form, you agree to abide by the terms laid out in this waiver and all other protocols set out by The Rosemary Breman School of Dance. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.*

Rosemary Breman School Of Dance