Please take a moment upon registration to review and complete the following forms regarding your students participation at Music in Motion Dance Academy.


We are excited and honored to feature our talented dancers and community in various areas on our website, promotions and social media pages. I hereby grant permission to Music in Motion the rights of my image, and likeness. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image. By signing this release I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet, film, print or promotional settings. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. By signing this form I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational or promotional purposes.
Consenting Guardians Name *
Consenting Guardians Name
Students Name *
Students Name
By including your electronic signature here, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement.
Date *
Date

I agree to abide by the rules and the regulations of the Academy. I guarantee the attendance of the student and the monthly payment of tuition on the first of each month. I will be responsible for the $10 late fee assessed for any tuition received 10 or more days after due date. I will notify the Academy in writing 30 days before the students discontinues classes or I will be responsible for the following month's tuition. To my knowledge, there is no medical reason why this student should not participate in the program. My child will participate at his/her own risk and I shall not hold Music in Motion Dance Academy, it's directors, employees, or agents responsible for any loss, claim or injury as a result of his/her participation.
Guardians Name *
Guardians Name
Students Name *
Students Name
Phone *
Phone
Address *
Address
By including your signature here, you are signing this agreement electronically. You agree this electronic signature is the legal equivalent of your manual/handwritten signature on this agreement.
Date *
Date