South Asian Arts Movement Society - Summer Term 2015 - Registration Checkout using PayPal

South Asian Arts Movement Society - Summer Term 2016 - Registration

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SECTION A: ALL CLIENTS PLEASE COMPLETE

Participant First Name: *

Participant Last Name: *

Date of Birth: *

Date

Parent Name (complete if participant is under 18 years of age - please type "NA" if not applicable): *

Primary Email Address: *

Home Phone: *

Mobile Phone: *

Mailing Address: *

City: *

Postal Code: *

Email is our primary method of communication with you; by providing your email you consent to recieve emails from us.

Please Choose your Classes/Courses carefully below:

Children's Bollywood Dance Summer $ 108.00 CAD

Adult Just-For-Fun Bollywood Dance $ 108.00 CAD

Children's Kathak Level 1 $ 126.00 CAD

Beginner Kathak Level 1 $ 189.00 CAD

Beginner Kathak Level 2 - Introduction for accelerated learning $ 189.00 CAD

SAAM Annual Membership $ 15.00 CAD

Total $ 0.00 CAD

ALL CLIENTS , PLEASE NOTE: The studio does not provide make-up classes for ANY registered programs.

SECTION B : ALL CLIENTS PLEASE COMPLETE.

Glossary of terms: Studio/Club refers to all organizations using the space for commercial purposes including South Asian Arts Movement Society, AKtion Fitness Ltd. and any of their contractors.

ALL PARTICIPANTS - Liability Wavier: ASSUMPTION OF RISK OF INJURY AND LIABILITY WAIVER: I assume all risks of injury and waive all rights to pursue money damages or any other relief of any kind as a result of anything occurring at or near the Club/Studio Location or any other venue used by or it’s employees, officers, directors or other representatives (including but not limited to dance and/or fitness instructors and/or personal trainers). In the event I am injured while on a property used to conduct classes, I will hold harmless the Studio/Club and all of its owners, shareholders, employees, agents, representatives, successors and assigns from all claims of any sort for damages or relief, including but not limited to claims for contribution. I acknowledge there is possible danger connected with any physical activity (including the dangers of physical injury and death) and knowingly and voluntarily waive my right to make a legal or equitable claim of any sort against the Studio/Club and all of its owners, shareholders, employees, agents, representatives, successors and assigns from all claims of any sort for damages or for other relief, including but not limited to claims for contribution. This assumption of risk and wavier of liability applies to my family members, successors, heirs, and assigns. PHYSICAL CONDITION AND NO MEDICAL ADVISE: I represent that I am in good physical condition and have no medical reason or impairment that might prevent me from my participation or intended use of the Studio/Club and the services offered. I acknowledge that the Studio/Club and all of its owners, shareholders, employees, agents, representatives, successors and assigns will not and cannot provide me medical advice relating to my physical condition and ability to use the facilities/participate in fitness, dance or yoga programs/classes. If I have any health or medical concerns now or after joining a fitness, dance or yoga class, I will discuss them with my doctor before attending & participating in any classes or using the Studio/Club’s services. DEATH AND DISABILITY: If I die or become totally or permanently disabled, upon reasonable written notice to the Studio/Club Owner of the death or disability, either I or my estate may cancel this agreement and receive a pro-rata refund for my unused sessions/classes. CANCELLATION AND REFUND: To cancel this agreement, the client must notify the Club/Studio Management in writing. FOR FITNESS (including Dance-Fitness) CLIENTS, no refund will be given outside the 5th day after this agreement is signed unless for verified medical reasons. For DANCE CLIENTS, a refund of unused classes, MINUS 10% administrative charges, can be provided upon withdrawal from any dance term except in the case a SPECIAL BONUS OFFER WAS PROVIDED or DISCOUNTED PRODUCTS/SERVICES ARE PROVIDED WITH THE REGISTRATION, INCLUDING A DISCOUNT ON REGISTRATION FEES, IN WHICH CASE, ALL SALES ARE FINAL, NO REFUNDS ARE PERMITTED. I, the undersigned, waive and release the Studio/Club and its employees, officers, directors or other representative from any and all claims in any way connected with my participation in this program. This agreement is binding on my heirs and executors. I understand that ALL aspects of this wavier apply to any children that I bring with me to any of the classes/programs/events/meetings or gatherings offered by Studio/Club. I acknowledge that I am the legal guardian of the children listed on this form. By signing this document, I acknowledge that I have read or heard this document in its entirety and that I fully understand it. I have asked any questions that may have occurred to me and have been answered to my satisfaction. A legal guardian/parent must sign for any participants under the age of 18 years. YOUR TYPED SIGNATURE BELOW WILL BE CONSIDERED IDENTICAL TO YOUR ACTUAL SIGNATURE IF THIS FORM IS SUBMITTED ELECTRONICALLY. *

Date Signed: *

Date

*The information collected by the offices of the Studio/Club will be held confidential and we take our best efforts to protect your privacy. You will release the Studio/Club and all representatives from any harm or liability if any non-authorised persons unlawfully gains access to your information for his/her/it"s personal gain in a fraudulent manner.

Please remember to bring your own water bottles. South Asian dancing is primarily done barefoot.

Section C: Usage of Video Footage & Photography Policy: A) Participants actively engaging in any SAAM programs or programs managed by SAAM may have their video and photos featured in magazines, television ads, on the Internet and other marketing materials on a regular basis. B) All participants and their applicable Guardians release SAAM and its heirs, representatives, employees, directors, contractors, affiliates and assignees from any liability related to any improper, distasteful or unlawful usage by a 3rd Party of pictures or video of participants. *

I Agree to Section C. I do not agree to Section C.