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I have chosen to have my child participate in dance instruction given by Cultivate Dance Collaborative dance studio. I acknowledge that I understand the nature of the activities my child will be participating in and that my child is in the proper physical condition and capable of participating in the related activities, understanding that Cultivate Dance Collaborative is not in any way responsible for making such a determination.

In consideration of my child's enrollment in any dance instruction program, I understand and agree on behalf of myself and my child, to release, hold harmless, and discharge Cultivate Dance Collaborative from all claims, costs, liabilities, expenses or judgments, including attorneys fees and court costs for any occurrences in connection with any dance instruction. I assume all risks to my child in connection with any instruction and further release Cultivate Dance Collaborative and its owner and staff from liability for any injury sustained by my child while he or she is enrolled in any dance instruction program, including all risks reasonably connected with such activity whether foreseen or unforeseen.

I understand that Cultivate Dance Collaborative is not responsible for my child or other children under my supervision who are left unsupervised in the common areas and areas surrounding the dance studio and that Cultivate Dance Collaborative will only be supervising my child when he or she is participating in scheduled dance activities, programs or instruction.

I understand that Cultivate Dance Collaborative is not responsible for personal property that is lost, damaged, or stolen while I or my child is at or on Cultivate Dance Collaborative property.

I acknowledge and agree that it is my responsibility to maintain my own accident and health insurance coverage that provides adequate coverage for myself and my child participating in Cultivate Dance Collaborative's activities and that Cultivate Dance Collaborative does not provide accident or health insurance for those participating in its instruction, activities or programs.

Agreement of Classroom Protocol: I understand that the accepted practice and methodology of professional dance training entails hands-on and other forms of physical contact with instructors and other students and that this is necessary for a student to learn at an appropriate pace. I understand that if there is currently, or ever would be, any reason why I should not be touched, or should only be touched in a specific way, it is my responsibility to inform EACH instructor as to what is acceptable and to discuss any related physical or mental issues with them.

I understand that there are no refunds on payments of any kind (unless discussed with both studio owners). I will not dispute any charges, instead I will bring any questions or concerns of payments/charges to the studio owners.

I HAVE FULLY INFORMED MYSELF AS TO THE CONTENTS OF THIS RELEASE AND HAVE READ THE SAME PRIOR TO AGREEING.

Acknowledgement of Risk or Injury
For the consideration of me and/or my child, for whom I am responsible and represent, I/we acknowledge that we participate in the workshop, class, and/or performance of our own volition and choice. I/we recognize that performing in such a workshop, class, and/or performance has or creates a greater risk of injury to myself or my child.


Waiver of Claim for Injury
I agree to waive and relinquish all claims that I or my child may have for injuries or damages as a result of participating in the workshop, class and/or performance or using the facilities or equipment against Cultivate Dance Collaborative, its officers, directors, agents, employees, and/or affiliates. This release is intended to release any and all claims that I/we may possess as a consequence in any fashion of our participation in the workshop, class and/or performance. Accordingly, I do hereby fully release, discharge from liability, and hold harmless Cultivate Dance Collaborative, its officers, directors, agents, employees, volunteers, and/or affiliates from any and all claims for injury, including death, damages, property damage, or loss, which I or my child may have or which in the future we may accrue on account of participation in the workshop, class and/or performance or use of the facilities or equipment.


Indemnity and Defense
I further agree to indemnify, hold harmless, and pay defense costs and defend Cultivate Dance Collaborative, its officers, directors, agents, employees, volunteers, and/or affiliates from any and all claims resulting from injuries, including death, damages, property damage, or loss sustained by me or my child arising out of, connected with, or in any way associated with the activities of participating in the workshop, class and/or performance or using facilities or equipment.


Recognition of Termination
The undersigned recognizes the right of the director of Cultivate Dance Collaborative in his or her absolute discretion, to terminate a participant's involvement, class, and/or performance at any time due to disciplinary issues, medical issues that might jeopardize the participant, or some else health, safety, or wellbeing, or concerns about the completion of the workshop, class and/or performance in a satisfactory manner, which it is acknowledged, is solely the decision of the director of Cultivate Dance Collaborative.


Medical Release
I/we hereby give permission for any and all medical and/or dental attention to be administered to myself or my child in the event of accident, injury, sickness, etc., under the direction of the bearer of this letter until such time as we may be contacted. I/we assume the responsibility for the payment of any such treatment.

(Please submit any medical information by going to Account > Students > Click on your Students' name > scroll down and enter info in the Medications box/ Allergies box/ Special Needs box/ Primary Doctor if needed)

Participation Agreement:
Each member (or their parent or guardian for members 17 and under) is required to sign this participation agreement to acknowledge understanding of the participant's responsibility to Cultivate Dance Collaborative, fellow members, and audiences. If you have any questions before signing, please ask the directors of Cultivate Dance Collaborative.

Facilities: I am aware that Cultivate Dance Collaborative is responsible for the care of the facilities and that this is a shared space with Shape It Up Fitness. Students must assist in maintaining a clean and organized space. The students will help clean up after each class, and they will not interact with objects in the space that are not the property of Cultivate Dance Collaborative. I acknowledge that the entrance to Cultivate Dance Collaborative is in the back of the building, and I will not use the entrance located on Main Street as this is the entrance for the other business.

Social Media: I agree not to post videos or photos on social media that violate copyright laws that disparage Cultivate Dance Collaborative's reputation, or that put Cultivate Dance Collaborative in danger of copyright infringement or lawsuits.

Convenience Fee:
I acknowledge that my CC or ACH payment method will be charged and additional convenience fee of:
3.05% + $0.30 per CC transaction
1.00% + $0.20 per ACH transaction
In order to waive these fees I know that I have the right to pay by either cash/check, and that my payment needs to be brought in before or by the Due Date.

Refunds: There are no refunds given. Payment is required for classes on the posted due dates of each charge. No refunds are given at this time unless further discussed with Owners Madelyn Burnham or Melissa Brown Guenther. If there is an emergency contact the studio owner directly at CultivateDanceCollaborative@gmail.com

I hereby give permission for images of my child, captured during dance classes, dance rehearsals, dance performances and general studio events through video, photo and digital camera, to be used solely for the purposes of Cultivate Dance Collaborative's promotional material and publications, and waive any rights of compensation or ownership thereto.