Student Name *

First Name

Last Name

Date of birth *

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DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Fathers Name

First Name

Last Name

Mothers Name

First Name

Last Name

Emergency Contact *

First Name

Last Name

Physicians Name

First Name

Last Name

Consent

My signature will indicate my consent to have my child participate in Dance Fever Inc. I hereby release Dance Fever Inc. from all claims for damages to person or property from any accident or injury, which is caused or arises from participation at Dance Fever Inc., or from contract of communicable disease. This includes COVID-19 and any future novel disease. Dance Fever Inc. is not responsible for any lost, damaged, or stolen articles. I am aware that no refunds will be given for costume deposits, competitive entry fees, or for any other payments that have been processed. If my child is unable to continue dance and costumes have been made, it is my responsibility to pay all remaining costume balances. All pictures and videos affiliated with Dance Fever Inc. may be used for the purpose of advertising or promotion, unless I have specifically requested otherwise. I am aware that 9 post-dated cheques are required upon registration and that NSF cheques will be subject to a $35 administrative fee. Dance Fever Inc. reserves the right to cancel classes for any reason it feels appropriate without financial compensation. No refunds will be given for missed classes, including classes missed due to illness, injury, or vacation or classes that may be cancelled due to inclement weather. No refunds will be given for monthly payments if a dancer is unable to continue dance due to an injury sustained either in dance or another activity. Payments will not be transferred to another sibling or used as a credit for the following season. It is my responsibility to stay informed regarding studio events and important dates, and to familiarize myself with the Dance Fever Inc. Handbook. I have read and agree to adhere to all of Dance Fever Inc.’s competitive team policies.

I Agree

Date

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DD

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Time

Hour

Minute

Second

AM PM