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I authorize the Diane Matthews School of Dance Arts (DMSODA) to automatically deduct my seasonal family registration fee and monthly tuition payment in this transaction. For automatic tuition payments each additional month, I will sign up separately by enrolling using the AUTO PAY setting. I understand that it is my responsibility to notify the office of any card and or customer changes such as a new card, updates to expiration dates, change in name or mailing information etc. Due to increasing credit card processing rates, beginning September 1, 2018, all electronic payments on line and in the studio will incur a convenience fee of 2.75% of the transaction.
I understand that participation in dance as in any physical activity has risks due to the physical demands that are placed on an individual during such activity and recreation. During such physical activity there is potential risk of physical injury. I agree that I am responsible for my or my child’s participation and for their physical and emotional well-being. I understand that the program activities are voluntary. I am choosing for my child to participate in each dance activity, rehearsal, or performance to whatever degree possible-with all physical, emotional and medical conditions considered.
I affirm that my child’s health is good, and is not under a physician’s care for any undisclosed condition that bears upon their fitness to participate in dance, physical education and recreation. I willingly and knowingly assume risk, for my child, myself, my heirs, family members, executors, administrators and assume all risk of physical injury and emotional upset which may occur during any aspect of the program; and hereby agree to hold the DMSODA, its independent contractors, instructors, facilitators and volunteers harmless for any liability arising out of my child’s participation in the program.
This release does not however, apply to any physical injury or emotional harm caused by negligence or willful misconduct of the DMSODA Staff.
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