260 Centrum Blvd, Orleans, ON K1E 3P4, Contact: (613) 834-4329
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Summer Registration Form

Home / Summer Registration Form

Registration Form

Summer Registration Form 2024

Student Information

Programs or curriculum choices *

Parent/Guardian Information

I agree, to receive the school newsletter via email.
How did you hear about our school?

Emergency Contact Information

Required Policies and Agreements

Medical release

In case of physical injury or medical emergency, I hereby authorize DanceR Studio to make necessary arrangements to transport myself or my child to a medical treatment facility as necessary. All such transportation and medical treatment will be at my sole cost and expense. In extreme emergency, or if my child is under 18 years of age, I understand that DanceR Studio will attempt to notify the person(s) I have named on the registration form as my emergency contact(s) of my condition and how to reach me.

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Client waiver, Photo Release, and Payment Agreement

Waiver of Liability (In-Person)
1693981 Ontario Inc. doing business as DanceR Studio (“Dancer Studio”) values each dancer, both as an individual and as a dancer. We will make every effort to preserve the safety and security of the dancers. It is our aim to build self-esteem through achievement in dance.

I, the parent or guardian named below, will not hold DanceR Studio or its employees or volunteer staff responsible for any accident or injury which may occur during the time which the dancer, named above, is present at DanceR Studio dance school or taking part in any of its events. I understand that every effort to ensure the safety of my child will be taken while at the school or event. I will not undertake any legal proceedings against DanceR Studio if such accident or injury should occur.

Photo Release
DanceR Studio creates memories by photograph and video recordings in class, at rehearsals and during performances.

I, the parent or guardian named below, consent to the inclusion of the image of my dancer, named above, in these photos and video recordings. I understand that images captured by the dance school are and remain the property of DanceR Studio, and may be used in its publicity and advertising, without payment therefor. Students, or parents of students who are minors, who do not wish to comply with this policy must notify DanceR Studio prior to participation in class.

Payment Agreement
I, the parent or guardian named below, being responsible for the dancer named above, agree to make tuition fee payments to DanceR Studio according to the schedule agreed upon, or as amended from time to time.

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Assumption of risk/Waiver of liability agreement relating to Coronavirus/COVID-19

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. As a result, federal, provincial, and local governments and federal and provincial health agencies recommend social distancing and have prohibited the congregation of large groups of people.

DanceR Studio has put in place preventative measures to reduce the spread of COVID- 19; however, DanceR Studio cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending DanceR Studio could increase 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 DanceR Studio, and that such exposure and 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 DanceR Studio, may result from the actions, omissions, or negligence of myself and others, including, but not limited to, DanceR Studio, employees, instructors, volunteers, and program participants and their families.

I voluntarily agree to assume all of the forgoing 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 DanceR Studio or participation in studio programming (“Claims”). On my behalf, and on behalf of my child(ren), I hereby release, covenant not to sue, discharge, and hold harmless DanceR Studio, it’s employees, instructors, agents, and representatives, of and from the Claims, including 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 DanceR Studio, it’s employees, instructors, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any DanceR Studio program or classes.

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BY REGISTERING AND PAYING FOR ANY CLASS, EVENT, PRIVATE LESSON, OR OTHER ACTIVITY THROUGH DANCER STUDIO, YOU ARE AGREEING TO ALL OF THE ABOVE CONDITIONS AND WAIVERS. PLEASE DO NOT HAVE YOUR CHILD/YOURSELF PARTICIPATE IN ANY CLASS OR EVENT UNLESS YOU ACCEPT AND AGREE TO ALL OF THE TERMS IN THIS AGREEMENT.

Client signature and Consent

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Contacts

  • 260 Centrum Blvd.
  • Orleans, ON, K1E 3P4
  • mikiwhytedance@hotmail.com
  • (613) 834-4329

Open Hours

  • Monday 5:00-8:30pm
  • Tuesday 4:45-9:00pm
  • Wednesday 5:30-9:15pm
  • Thursday 4:45-9:30pm
  • Friday 4:45-7:15pm
  • Saturday 9:00-1:30pm
  • Sunday 9:00-1:00pm

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