DMO liability Waiver and policy form

To register for classes at DMO please fill out the following waiver

I/we realize that participation in dance classes and activities could involve some possible personal injury. Despite precautions, accidents and injuries may occur. By signing this release form, I/we (the dancer and parent/guardian) assume all risks related to the use of any and all spaces used by Dance Molinari.

I/we agree to release and hold harmless DANCE MOLINARI, including its teachers, dancers, staff members, and facilities used by both entities from any cause of action, claims, or demands now and in the future. I/we will not hold DANCE MOLINARI liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes/lessons. Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by DANCE MOLINARI. I acknowledge that my son/daughter is currently covered under a medical insurance policy for any injuries that could occur.

In the event that I/we should observe any unsafe conduct or conditions before, during, or after my/our classes, I/we agree to report the unsafe conduct or conditions to Janine Molinari, instructor, or staff member as soon as possible. Cancellation of Private Lessons: A private lesson may be canceled up to 24 hours before the scheduled time, with the exception of Mondays and Holidays, in which 48 hours notice is required. Any cancellation within the 24/48 hour time will be charged the full private lesson fee. Payment for untimely cancellations must be paid prior to admittance to any further class or private lesson.

Payment/Visitation for Private Lessons: Private lessons must be paid in full prior to the beginning of the lesson. A check may be payable to DANCE MOLINARI for the private lesson. Cash only will be accepted for the studio space. Parent(s) may come in only for the last ten minutes of the private lesson.

Payment for Classes: Cash only for any classes on Tuesdays, Thursdays, and Saturdays. Exact amount is preferred.

Returned Check Policy: A flat fee of $25 will be charged for every returned check.

Cell Phone/Video/Photography Policy: Videoing of any audition combinations will be at the discretion of the teacher or casting director.

Scheduling/Communication: ALL comments, questions, and scheduling of private lessons must be made by email atdancemolinari@gmail.com.

Student's First Name

Parent's First Name

Parent Phone Number

Emergency Contact

Student's Last Name

Parent's Last Name

Parent Email

Emergency Contact Phone Number

Relation

Parent Signature

Today's Date

I have read and understand the above waiver and policy form.

Thanks for submitting!