En Pointe Dance & Fitness Summer Intensive Registration Form

Parent/Guardian Information

Emergency Information

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by En Pointe Dance & Fitness, LLC during the selected dance intensive. In exchange for the acceptance of said child’s candidacy by En Pointe Dance & Fitness, LLC , I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless En Pointe Dance & Fitness, LLC. and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against En Pointe Dance & Fitness, LLC . including all teachers, councelers and affiliates, all participants, and, if applicable, owners and lessors of premises used to conduct the event.

I understand that dance intensive payments are non refundable, but can be transfered to another age appropriate weeek if avaiblable.

Medical Release and Authorization

As Parent and/or Guardian of the  above named child, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention.

Permission is also granted to the En Pointe Dance & Fitness, LLC. and its affiliates including teachers, counselers and and staff  for minor injury treatment, or emergeny medical treatment prior to the child’s admission to the medical facility if deemed necessay. 

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Confirmation

BY ACKNOWLEDGING AND SIGNING ABOVE, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.