Name*

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Dance Class Choice*

How Many Children Would You Like To Register?*

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Mother's Name

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Father's Name

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Emergency Contact Information

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Medical Information

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Consent

I hereby certify that to the best of my knowledge, my child is healthy and in good physical condition and can participate fully in this program. All current medical conditions and any medications required have been communicated to Rugcutterz Danz Artz Inc. I understand the inherent risk involved in the physical activity of participating in Rugcutterz Danz Artz Inc. programs and I release Rugcutterz Danz Artz Inc and its instructors, directors, managers and owners from any liability, current or future in case of accident, injury or contract of communicable disease including COVID-19 and any other future novel disease. I affirm that neither I, nor any member of my household has been diagnosed with the COVID-19 virus within the past 30 days. I agree to immediately inform Rugcutterz Danz Artz Inc if I or any member of my household is diagnosed, and I agree to discontinue any programs for the quarantine period outlined by my medical professional. I understand that all classes will be conducted in the safest possible manner by instructors and studio representatives. I also understand that Rugcutterz Danz Artz Inc will not be liable for failure to perform their contractual obligations due to an event of force majeure and frustrated contract. In addition, I hereby give permission to Rugcutterz Danz Artz Inc to photograph and video my child for class purposes and that these photos and/or videos may be used for advertising purposes including all social media platforms. I understand that through my family's participation in any and all Rugcutterz Danz Artz Inc programs that we are agreeing to all the terms and conditions set forth.

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Children Dance Registration

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