Authorization for Automatic Payment:

For families choosing to spread their tuition out over the year, we will be setting you up on a convenient automatic payment system. To cancel this installment payment plan if classes are discontinued, you must notify Movements In Motion Dance Studio's office before the 1st of the month. A Drop Class Form must be filled out which can be obtained from the office. If you do not do so, your account will continue to be billed until the end of this agreement or until such written notice is received. If notice is received after the 1st of the month, you are still responsible for that month's tuition.

I authorize Movements In Motion Dance Studio to charge my credit card or my checking account on the 1st of each month and be applied towards my tuition installment. Monthly Option (These automatic charges will begin October and the last tuition payment will be processed May ) I will be paying for September along with membership fee the day I sign this form, via check, cash or credit card. I also authorize Movements In Motion Dance Studio to charge my credit card or my checking account for costume deposits/balances, or any other monthly balances including any late fees that I have occurred that I owe.

Should my credit card transaction be declined or returned back due to any other reason, I understand that a service charge of $15.00 will be assessed and billed to me direct. If after the 10th payment is still not made an additional $15.00 will be assessed and billed to me direct. There is a NSF fee on returned checks of $30.00. I agree to remit this fee to Movements In Motion Dance Studio upon receipt of invoice. It is my responsibility to provide any updated account information such as expiration dates, new account number, etc.

In the event my credit card transactions are declined or my checks are returned for NSF on a repeated basis, I understand that continued participation in the Automatic Payment Plan may be terminated. If this occurs, I understand that to ensure non-interruption of my child’s dance education, I will be required to remit any past due tuition, late fees, as well as the remaining year’s tuition. This payment will be non-refundable.

EVERYONE will be put on a monthly payment schedule, however if you want to pay in full (prior students only) or quarterly please email movementsinmotiondancestudio@gmail.com

***NO REFUNDS WILL BE GIVEN ONCE THE PAYMENT IS PROCESSED***

Movements In Motion Dance Studio
Liability Policy and Waiver of Release

In participating in any dance class and any other activity with and/or organized by Movements In Motion, I hereby waive and release all claims, liabilities, actions, damages, costs or expenses of any nature whatsoever for injuries I might sustain, known or unknown, arising out of the class or activity now or at any time in the future.

I understand that certain dance forms and styles may need corrections which may
include physical contact by the instructor.

I recognize and acknowledge that there is a risk associated with participating in the performance and instruction of dance and I agree to assume the total responsibility for such.

I accept liability for any property damage that may occur as a result of my instruction and/or performance with and while I am on the premises of Movements In Motion.


I agree to indemnify and hold harmless Movements In Motion or any of the studio's instructors from and against any and all liabilities, claims, actions, damages, costs or expenses of any nature whatsoever, whether in law or equity, known or unknown, incurred by Movements In Motion and arising out of or in any way related directly or indirectly, to my participation in a class and/or activity and/or performance.

I agree to the terms outlined in the Liability Policy Waiver of Release.


Authorization for Automatic Payment For Dance Tuition ONLY:

For families choosing to spread their tuition out over the year, we will be setting you up on a convenient automatic payment system. To cancel this installment payment plan if classes are discontinued, you must notify Movements In Motion Dance Studio's office before the 1st of the month. A Drop Class Form must be filled out which can be obtained from the office. If you do not do so, your account will continue to be billed until the end of this agreement or until such written notice is received. If notice is received after the 1st of the month, you are still responsible for that month's tuition.

I authorize Movements In Motion Dance Studio to charge my credit card or my checking account on the 1st of each month and be applied towards my tuition installment. Monthly Option (These automatic charges will begin October and the last tuition payment will be processed May) I will be paying for September along with membership fee the day I sign this form, via check, cash or credit card. I also authorize Movements In Motion Dance Studio to charge my credit card or my checking account for costume deposits/balances, recital fees or any other monthly balances including any late fees that I have occurred that I owe.

Should my credit card transaction be declined or returned back due to any other reason, I understand that a service charge of $15.00 will be assessed and billed to me direct. If payment is still not made by the 15th, an additional $15.00 will be assessed and billed to me direct. There is a NSF fee on returned checks of $30.00. I agree to remit this fee to Movements In Motion Dance Studio upon receipt of invoice. It is my responsibility to provide any updated account information such as expiration dates, new account number, etc.

In the event my credit card transactions are declined or my checks are returned for NSF on a repeated basis, I understand that continued participation in the Automatic Payment Plan may be terminated. If this occurs, I understand that to ensure non-interruption of my child's dance education, I will be required to remit any past due tuition, late fees, as well as the remaining year's tuition. This payment will be non-refundable.

EVERYONE will be put on a monthly payment schedule, however if you want to pay in full (prior students only) or trimester please email movementsinmotiondancestudio@gmail.com

***NO REFUNDS WILL BE GIVEN ONCE THE PAYMENT IS PROCESSED***

COVID-19 Screening and Consent Form


I, ________________________________, knowingly and willingly consent to have my child participate in programs with Movements In Motion Dance Studio , during the global COVID-19 pandemic. I understand that the COVID-19 virus and it's variants has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. I confirm that I, my child as well as all members of my household have not in the past 14 days had any of the following symptoms of COVID-19 listed : fever, shortness of breath, cough or flu like symptoms, runny nose, sore throat or recent loss of taste or smell. I also understand that certain travel may increase risk of contacting and transmitting the COVID-19 virus and it's variants. Therefore, I verify that I, my child, nor anyone in my household have not traveled outside the United Sates in the past 14 days to countries that have been affected by COVID-19 and it's variants.

I make this decision for my child of my own free will relying upon my knowledge and judgement of any injury they may have sustained or possible transmission of COVID-19 during participation in programs and my decision to release has not been affected by any false statements or representations pertaining to those injuries. I understand that this action is my decision.

I also understand and agree to follow Movements In Motion ‘s COVID-19 Protocols as listed in the attached flyer. It is important that we follow these protocols to make sure the studio is following all CDC guidelines.

I also understand that each dancer MUST do the daily screening upon entrance and if my child has a fever of 100.5 or higher they will be sent home. I also understand that I am not permitted to send my child if they exhibit any signs of illness.

I agree to indemnify and hold harmless Movements In Motion or any of the studio’s instructors from and against any and all liabilities, claims, actions, damages, costs or expenses of any nature whatsoever, whether in law or equity, known or unknown, incurred by Movements In Motion and arising out of or in any way related directly or indirectly, to my participation in a class and/or activity and/or performance during this COVID-19 pandemic.

I agree to the terms outlined in the COVID-19 and it's variants Screening and Consent Form.