I authorize Ashland Dance Company to charge my credit card or bank account for agreed upon purchases. I understand that my information will be saved to file for future transactions on my account.
You may cancel this authorization at any time by contacting us. This authorization will remain in effect until cancelled.

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Jump Start Dance during the selected class. In exchange for the acceptance of said child’s candidacy by Jump Start Dance ., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Jump Start Dance 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 class sessions.

In case of injury to said child, I hereby waive all claims against Jump Start Dance including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

I am aware that dancing and the physical movement associated with it places stress on the body and carries with it the risk of physical injury. On behalf of my child and myself (and if I am no longer a minor, on my behalf), I assume the risk and agree that Jump Start Dance shall not be liable in any way for injuries sustained during attendance at Jump Start Dance, it’s successors and it’s assignees for all personal injuries caused by, or arising from, the above described activities or any activities related thereto.

I understand that, in order for all children enrolled in class receive the best dance education experience possible, Jump Start Dance reserves the right to re-assess placement of any child who is not ready to participate productively and safely.

Further I grant Jump Start Dance, it’s agents and employees permission to authorize any emergency medical treatment that may be required for my child or ward during their time in the session.

I hereby consent to and authorize the use and reproduction by Jump Start Dance of any and all photographs that have been taken of me and/or my child(ren) for any purpose, without compensation to me. All negatives and positives, together with the prints, and digital files are owned by Jump Start Kids. The company reserves the right to use these photographs in any sort of print or electronic publications.

I hereby acknowledge that I have read and understand the terms of this release.

I, the undersigned, have read this release/ authorization and understand all of its terms. I execute it voluntarily and with knowledge of its significance. I have executed this release/authorization on the day and year stated above

I furthermore attest that I have read and understand Jump Start Dance policies. Jump Start Dance reserves the right to terminate any student at any time for any reason.
I have read and understand all guidelines for Jump Start Dance.

Release waiver and assumption of risk:
I attest that my child is physically fit for the activity of dance, and is in good general health. Furthermore, I release Jump Start Dance Studio from any and all liability related to activities in dance class in Jump Start Dance Studio and any and all performances. I furthermore attest that I have received and understand a copy of Jump Start Dance Studio policies. JSDS reserves the right to terminate any student at any time for any reason.
I am aware that dancing and the physical movement associated with it places stress on the body and carries with it the risk of physical injury. On behalf of my child and myself (and if I am no longer a minor, on my behalf), I assume the risk and agree that JSDS shall not be liable in any way for injuries sustained during attendance at JSDS, it’s successors and it’s assignees for all personal injuries caused by, or arising from, the above described activities or any activities related thereto.
I understand that any time my child participates in any activities related to the private contract, my child is under the care and responsibility of the the vendor or individual fulfilling the private contract and I release and hold harmless any child care facility from the accountability, responsibility and care of my child during this time. I have read and understand all guidelines for Jump Start Dance Studio. I authorize Jump Start Dance Studio to charge my credit card above for agreed upon purchases. I understand that my information will be saved to file for future transactions on my account. *

I understand that, in order for all children enrolled in class receive the best dance education experience possible, JSDS reserves the right to re-assess placement of any child who is not ready to participate productively and safely.

Further I grant JSDS, it’s agents and employees permission to authorize any emergency medical treatment that may be required for my child or ward.

I, the undersigned, have read this release/ authorization and understand all of its terms. I execute it voluntarily and with knowledge of its significance. I have executed this release/authorization on the day and year stated above

Photograph Release:

I the parent/guardian (or student if 18+) authorize JSDS and /or it’s representative agent, or employee to use any photograph/likeness of my child (or myself) for any purpose, including publicity, choreographic archives, promotional materials and/or any other reason deemed appropriate by the artistic staff or marketing director.

Release waiver and assumption of risk: I attest that my child is physically fit for the activity of dance, and is in good general health. Furthermore, I release Jump Start Dance Studio from any and all liability related to activities in dance class in Jump Start Dance Studio and any and all performances. I furthermore attest that I have read and understand a copy of Jump Start Dance Studio policies. JSDS reserves the right to terminate any student at any time for any reason. I understand that any time my child participates in any activities related to the private contract, my child is under the care and responsibility of the the vendor or individual fulfilling the private contract and I release and hold harmless any child care facility from the accountability, responsibility and care of my child during this time. I have read and understand all guidelines for Jump Start Dance Studio. I authorize Jump Start Dance Studio to charge my credit card above for agreed upon purchases. I understand that my information will be saved to file for future transactions on my account. *