1. Does your child have any health condition(s), which may require EMERGENCY ACTION when he/she is at class (e.g. seizures, insect allergy, asthma, bleeding problem?
If Yes, Please Describe:
2. Should there be any restrictions of physical activity in class?
3. In case of an emergency in which you are unable to be reached, do you give your permission for your child to receive any necessary medical attention?
I, (Parent Name)
have enrolled (student’s name)
in a dance/gymnastics/movement program at Brenda’s Body Shop / Fun & Fitness from September 2011-May 2012. I hereby agree to the policies and procedures outlined in the information guide and payment booklet. Withdrawal Policy: Parents must submit a written letter requesting termination of classes. Withdrawal after November 30, you will pay 50% of the remaining yearly tuition. Withdrawal after January 5, the remaining yearly tuition is to be paid. Tuition fees are due by the 7th of each month, on the 10th of the month a $10 late fee will be added to overdue accounts. Registration and Recital Fees are non-refundable. I waive any possibilitiy of personal damage which may be blamed upon such a program in the future and accepts the responsibility for requesting such a program and assistance. I accept complete responsiblity for my child's enrollment and understand that the instructors of the program or sponsoring agency assume no liability. I, also give permission for my child's photo to be used for press releases, brochures, web site i.e. any printed promotional materials.
OUR CLASS RULES AND POLICIES ARE ON THE FOLLOWING WEBPAGE: http://www.brendasbodyshop.com/kids/policiesrules.html
Choose the classes you want: Check mark all that apply:
Gymnastics
• Ballet
• Tap
• Jazz
• Baton
• Hula Hoop
• Jump Rope
Non-competitive Sportaerobics
• Kindermoves
• Kinderkicks
• Move & Groove
• Hip Hop
• Other
I understand my private information will remain confidential.
- By submitting this form I agree to the terms, conditions, and policies set forth by Brenda's Body Shop