READ THIS AGREEMENT CAREFULLY BEFORE ENROLLING. THANK YOU!
You must be 18 or over to register for an account. I also agree to read the waiver, and policies on our website. By registering and enrolling in a UCPA LLC. Class, I agree that I will give at least one month's notice prior to withdrawing my student from class or be subject to the tuition and late fees.
PLEASE SEE THE WAIVER/RELEASE AGREEMENT BELOW
Parent Release Form for Photography and Videography
I, the undersigned, give permission for Umbiance Center for the Performing Arts to use video footage and / or
photographs of my child/ward, _________________________________. This usage may
include (but is not exclusive to) displaying publicly, distributing, or publishing, photographs,
and/or video of my child for use in materials that include, but may not be limited to:
- printed materials (eg - brochures and digital media. I agree that these images may be used without
further notification. I do understand that any identifying information including surname and
location will not be used in conjunction with any video or digital images.
Parent/Guardian signature __________________________ Date ______________
Health Information and Medical Release/Waiver Form
I, _________________, the parent/guardian of _________________________,acknowledge
that participation in dance is potentially dangerous and the is an inherent risk of injury
In allowing my child to participate in Umbiance Center for the Performing Arts activities, I hereby assume all the
risks associated with the performing arts. I understand the importance of myself and my child
following the instructions and rules set by their instructor/s, and I agree to release Umbiance Center for the Performing Arts and its employees of any and all liability which may arise as a result of my child’s participation in activities at Umbiance Center for the Performing Arts.
Waiver and Release Liablity Form:
I, ________________________________ (print your name) have chosen to have myself or my child, ______________________ (print child’name/ your name), participate in dance instruction given by Umbiance CPA LLC. I acknowledge that I understand the nature of the activities my child will be participating in and the possibility that despite precautions, accidents and/or physical injury may occur.
I/we agree to release and hold harmless Umbiance CPA LLC. including its teachers and staff members from any cause of action, claims, or demands now and in the future. I/we will not hold Umbiance CPA LLC. liable for any personal injury or any personal property damage or loss, which may occur on the premises before, during or after classes or which may occur at any UCPA. sponsored event outside the studio.
Furthermore I/we agree to read and follow the class and facility policies and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by UCPA. The policies can be found on our site at www.Umbiancedance.com under the studio policies tab.
By signing up through the DSP system I authorize and agree Umbiance Center for the Performing Arts may take and use photographs, videos or likenesses of myself or my child as needed for its record keeping, advertising, social media and/or public relations projects and that I have no rights to the same and will not be compensated for the same.
DROPPING A CLASS
Students may drop a class at any time. However, any class dropped after the second week will not be refunded. In addition, parents must give a 30-day notice to prevent additional charges. In order to for a student to be officially dropped from a class, a Drop Class Form must be filled out and turned in to the front desk. Not attending class does not disenroll the student from the class and additional fees may incur until a Drop Class Form is received. Drop Class Forms are available online and at the front desk and must be completed and turned in before your child will be removed from the class.
Tuition is always due on the 3rd of the month with a grace period until the 5th. A $20.00 late fee will be added after the 5th of each month and $5.00 each additional week the account remains delinquent. Tuition is paid each month (Sept - June) unless a drop form is received by the front desk. Tuition is nonrefundable after the second week.
*Signing or checking the appropriate box is proof that I have read and signed the UCPA STUDENT Handbook.
My signature or check in the appropriate box is proof of my intention to execute a complete and unconditional waiver and release of all liability pursuant to the terms herein, and agreement as to all terms and conditions contained above. I am of lawful age and competent to sign this affirmation.
I HAVE FULLY INFORMED MYSELF AS TO THE CONTENTS OF THIS RELEASE AND HAVE READ THE SAME PRIOR TO SIGNING.
Signature of Parent or Guardian:_____________________________________ Date:________________________________
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