Please Read and Sign
I am aware and fully understand that there are risks and dangers associated with participation in dance classes and different dance movements of the varied dance disciplines. These movements and activities could result in bodily injury, partial or total disability, or death. The social and economic losses and/or damages which could result from these risks and dangers could be severe. I acknowledge that it is standard teaching protocol that a Nutmeg Performing Arts Center LLC Instructor may physically touch students during his/her instruction and I will not hold Nutmeg Performing Arts Center LLC liable for such physical touching. I understand that these risks and dangers may be caused by the negligence of the participant or the negligence of others. There may be risks not known to us or not foreseeable at this time. Nutmeg Performing Arts Center LLC is not responsible for anything that is lost or stolen.
I accept and assume all such risks and responsibilities for the lessees and/or damages following such injury and/or disability however caused or alleged to be caused in whole or in part by the negligence of Nutmeg Performing Arts Center LLC, its instructors, independent contractors, hosts, other participants/students, sponsors, advertisers, owners, officers and lessees of the premises used to conduct the event or activity and each of them, their officers, directors, agents and employees. I agree that this consent and assumption of risk statement covers every event or activity sponsored by Nutmeg Performing Arts Center LLC.
Consent for Emergency Treatment: In cases of emergency, Nutmeg Performing Arts Center LLC is authorized to arrange for medical services for the student and I consent to appropriate medical and surgical service recommended by licensed medical professionals. I accept full responsibility for all costs of said medical care and any emergency treatments. Nutmeg Performing Arts Center LLC will not be responsible for the cost of any medical care or emergency treatments. I hereby waive all claims whatsoever in connection with such medical treatments. I agree that Nutmeg PAC LLC will not be held liable for and agree to hold Nutmeg Performing Arts Center LLC harmless from all liabilities, losses, damages or expenses related to the student’s participation in any activities at Nutmeg Performing Arts Center LLC.
I understand that when I pay in full that the payment is non refundable, Tuition is not monthly, but total owed for the season, and I accept that this reserves my dancer(s) spot for the season, and I am responsible for the entire amount stated at the beginning of the season, if my dancer(s) attend the entire season or not.
I HAVE READ THE ABOVE WAIVER, ADDITIONAL HANDOUT “IMPORTANT REGISTRATION INFORMATION,” THAT CONTAINED A BREAKDOWN OF THE STUDENT/PARENT RESPONSIBILITIES AND SIGN IT VOLUNTARILY. I HAVE READ THE STUDIO POLICIES AND UNDERSTAND THAT FAILURE TO ABIDE BY THESE POLICIES AND STANDARDS SET FORTH MAY REQUIRE DISMISSAL FROM THE STUDIO.
I ______________________________________________ (Parent’s Name), hereby represent to Nutmeg Performing Arts Center LLC. that my child(ren) _____________________________________ is of sound health and has no history of a medical or physical condition which could in any shape, manner or form place my child at risk because of said condition. I acknowledge that I have been informed by Nutmeg Performing Arts Center LLC. of the nature of the instruction my child will receive and that such instruction involves physical exercise, exertion and stress, which could result in injury and /or disability. Also have explained to my child what is expected to attend Nutmeg Performing Arts Center LLC.
Printed Name of Parent/Guardian: _________________________________ Date: ___________
Signature of Parent: ________________________________________________
Copies of this Document will be available on your Parent Portal, for Easy access login to a Computer or any Android/IOS Device.
Any Questions, please email us at Nutmegpac.llc@Gmail.com
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