I hereby have read and checked my option for payment on the J.M.B.S. Tuition and Fees contract and agree to abide by this signed contract. I understand that non-payment may hinder me or my child from being able to continue taking dance. I will notify JMBS immediately to avoid a non-suffiecient funds chare of $25.00 should I close my account or change bancks and fill out a new bank agreement pre-authorization form before the payment due is in effect. I understand my account will be turned over collection for nonpayment of services rendered.

Julie Moffitt Ballet School
MEDICAL RELEASE FORM
I, hereby give permission for any and all medical attention to be administered to my minor child/children in the event of accident, injury, sickness, etc., under the direction of the physician(s) listed under the medical information section, or at any necessary emergency facility, until such time as I may be contacted. I also assume the responsibility for the payment of any such treatment. This release is effective for the period of one year from the date accepted.

I agree to to all tuition and fees associated with my/my child's dance classes and understand that non-payment will result in me/my child not being able to continue lessons or perfomances.