Name of Student *

First Name

Last Name

Birthdate of Student *

MM

DD

YYYY

Phone *

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Please check any your student may be interested in learning: *

Ballet

Jazz

Tumbling

Modern

Contemporary/lyrical

Broadway

Swing

Hip-Hop

Tamborine/Streamers

Worship Dance

Choreography Fundamentals

Creative Dance

Any classes you as a parent would be interested in for yourself:

Deep Stretch

Worship Dance

Pilates

Adult Barré Ballet

Waltz

Swing

Broadway

Enrollment Agreement, Liability Waiver and Acknowledgment of Risk: READ AND SIGN BELOW 
REGISTRATION IS INCOMPLETE WITHOUT SIGNATURE AND MUST BE COMPLETED BEFORE CLASS I understand that And a Time to Dance is a business and a Christian ministry, and there may be reference to God and the Bible and a sharing of my faith. Payment is due prior to your first class. All tuition payments are non-transferrable and non-refundable, and are to be used only for the classes and student originally intended. Classes missed that have already been paid for do not roll over. If you let me know 6 hours an advance of an absence, I can arrange with you a make up class. Tuition follows a semester schedule. If your tuition is late, a late fee may be charged. Students remain automatically enrolled until otherwise notified. *

I agree to above statement(s)

Permission is granted Lydia Sawyer to use both photographs & videos of students for publicity purposes & social media platforms. *

I agree to above statement(s)

Waiver/Release For Communicable Diseases Including COVID-19 WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19 ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT In consideration of being allowed to participate on behalf of And a Time to Dance and related events and activities, the undersigned acknowledges, appreciates, and agrees that: 1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and, 
 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 
 3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, 
 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS And a Time to Dance, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law. 
 I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. 
FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION) This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM NEGLIGENCE OF ANY PERSONS, to the fullest extent provided by law. *

I agree to above statement(s)

I understand and agree that in participating in any dance class, workshop, rehearsal or performance, there is a possibility of physical injury or death. I voluntarily agree, therefore, to assume all risks and responsibility for any such injury or accident, which might occur to me or my child during any of Lydia Sawyer’s classes, rehearsals, performances, or activities. I voluntarily waive my rights and that of my heirs and assigns. I will not make claims against and also, exempt, release, and indemnify Lydia Sawyer, the owners of location, agents, volunteers, assistants, employees, guest artists, and/or students from any and all liability claims, demands, or causes of action whatsoever from any damage, loss, injury, or death to me, my children, or property which may arise out of or in connection with participation in any classes or activities conducted by Lydia Sawyer and And a Time to Dance. I understand that I should be aware of my child’s physical limitations and agree not to exceed them. If I am signing this waiver for my children, I certify that I am the parent or legal guardian and have the right to waive these rights. This agreement is between Lydia Sawyer, And a Time to Dance, and student/parent named below. *

I agree to the above statement(s)

I understand that I will continue to remain automatically enrolled every semester - until otherwise notified. *

I understand

I agree to consistently drop-off and pick-up my child on time to the best of my ability. I understand the importance of having my child to class on time, as warm up and stretching is essential to preventing injury, and may be disruptive to the rest of the class. I plan to be absent from as few classes as possible during the semester as every student’s presence is essential & valued for the sake of the class. This is understood with realistic expectations, grace and understandings. *

I understand

I understand that make-ups for missed classes are currently required for all intermediate & advanced levels, at your earliest available opportunity. *

I understand

I understand that participation in annual performances is highly encouraged for all classes & that my participation is important & valued. I understand that participation for all intermediate & advanced levels is currently required. *

I understand

Student Name *

First Name

Last Name

Parent/Guardian Name (if minor) *

First Name

Last Name

Date *

MM

DD

YYYY

I have read & understand above terms & agreements *

I agree

Join our ‘And a Time to Dance Fall 2024’ group on the BAND app. This is where updates & information will be posted! You may also make comments as well as ask questions on posts. Copy this link to join the group. https://band.us/n/adacAap3m1afI *

I joined the BAND group!