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2021 PRE REGISTRATION Form
Indicates required field
Student's Name (#1)
Date of Birth
Classes You Wish to Register For:
Student's Name (#2)
Date of Birth
Classes You Would Like to Register For:
Parent / Guardian's Name
I the parent or legal guardian of the children listed in this registration form realize that participation in dance classes and activities could involve some possible personal injury. Despite precautions, accidents and injuries may occur. By signing this release form, I/we (the dancer and parent/guardian) assume all risks related to the use of any and all spaces used by and programs, activities, rehearsals or shows run by DANCE WORKS BC and or GIBSONS DANCE CENTRE.
I/we agree to release and hold harmless DANCE WORKS BC and or GIBSONS DANCE CENTRE including its teachers, dancers, staff members, volunteers and facilities used by both entities from any cause of action, claims, or demands now and in the future. I/we will not hold DANCE WORKS BC liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes. Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by DANCE WORKS BC and or GIBSONS DANCE CENTRE.
I/we agree that DANCE WORKS BC and or GIBSONS DANCE CENTRE will be informed of any physical limitations my child has before starting any programs with Dance Works and or Gibsons Dance Centre and with the understanding that my child's doctor has approved participation in physical activities such as dance.
Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
Individuals who have travelled outside of Canada within the previous 14 days or who are sick or who have been in contact with someone who is suspected of having Covid-19 must not use the facilities or attend dance classes. This access may be withdrawn at any time based on health agency recommendations.
In response to efforts to contain the spread of COVID-19 coronavirus, I am aware that I am using the facilities at my own risk and will ensure that I will conduct myself in a way that is appropriate. I confirm that I have not travelled outside of Canada for the past 14 days and have not been in contact with anyone who is suspected of having COVID-19. I do not have any symptoms of COVID-19 including but not limited to fever, sore throat, coughing, aches, respiratory problems, dry cough, fatigue, diarrhea, loss of taste or smell, chest pain, rash on skin, discolouration of fingers or toes, headache. The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. Dance Works BC has put in place preventative measures to reduce the spread of COVID-19; however, Dance Works BC cannot guarantee that you or your child(ren) will not become infected with COVID-19. Attending any public spaces increases your risk and your child(ren)’s risk of contracting COVID-19. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending Dance Works BC and or Gibsons Dance Centre. And that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at Dance Works BC and or Gibsons Dance Centre may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Dance Works BC and or Gibsons Dance Centre employees, volunteers, and program participants and their families.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at Dance Works BC and or Gibsons Dance Centre or participation in programs at the Dance Works BC and or Gibsons Dance Centre studios. On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the Dance Studios, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of Dance Works BC and or Gibsons Dance Centre, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Dance Works BC and or Gibsons Dance Centres Programs.
I grant Dance Works BC and or Gibsons Dance Centre permission to use photographs, videotapes, recordings or any other record of me as a participant or my child in the event for any legitimate purpose.
I consent to have medical treatment that may be deemed advisable in the event of injury, accident and/or illness during any program, event or activity. I release Dance Works BC and or Gibsons Dance Centre and all persons participating in any such medical treatment from all responsibility for any such actions. I have read, understand, and agree to the above terms of participation and the assumption of risk of participation and release all liability.
I, the parent or guardian indicated by name in this registration form, understand that I am taking sole responsibility for the tuition, registration and costume fees associated with the classes once I have completed registration. I understand that any payment arrangements with other family members, including the other biological parent of said child who is not residing in the same residence as myself, is my sole responsibility to organize. I understand that Dance Works Academy or Gibsons Dance Centre is unable to bill anyone other than myself for fees associated with my child's class unless a PAYMENT AGREEMENT FORM signed by any other party taking responsibility for payment is handed into the Dance Works (Gibsons Dance Centre) Office or appropriate court documents naming both parents responsible for payment can be produced. For families who are in need of a PAYMENT AGREEMENT FORM please email: email@example.com
I have read the Liability Waiver & Payment Agreement and accept its terms
Yes, I have read and agree
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