GUEST / PARTICIPANT DETAILS:
Participant(s) First Name
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Participant (s) Last Name
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Parent or Guardian Names if applicable.
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Participant Date of birth (dd/mm/yyyy)
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
We ask for DOB to ensure you meet the age minimums for the workshop.
Email Address
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Email Opt-In
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Yes I would like to get more info about dance classes, workshops and events in the future. I understand my info is safe and I hate spam so SAAM will not over-send emails to my inbox. I understand I can unsubscribe anytime.
Nope, not interested in dance stuff. Don't add me to the email list.
Phone Number
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Adult Bollywood Dance Workshop
$29.99 CAD
$
29.99
CAD
Final Sale.
Total
$0.00 CAD
$
0.00
CAD
REFERRAL INFORMATION
Please share with us information on how you found us.
Referral
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FACEBOOK
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SAAM - website/email
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ALL CLIENTS PLEASE READ SECTION D BELOW AND TYPE YOUR SIGNATURE IN THE BOX.SECTION D: WAIVER ALL PARTICIPANTS - Liability Wavier; please read carefully. Glossary: "Club/Studio" refers to South Asian Arts Movement Society, The Balance Code Yoga & Wellness Ltd. Assumption of Risk of Injury and Wavier of Claims: 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 the Club/Studio or its employees, officers, directors or other representatives (including but not limited to dance and/or fitness instructors and/or personal trainers and/or artists managed by the Club/Studio and/or contractors of any type). In the event I am injured while on a property the Club/Studio uses to conduct classes, performances, or workshops, I will hold harmless the Club/Studio and all of its owners, shareholders, directors, volunteers, sub-contractors, 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 Club/Studio and all of its owners, shareholders, directors, volunteers, sub-contractors, 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 Advice: 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 Club/Studio and the services offered. I acknowledge that the Club/Studio and all of its owners, shareholders, directors, volunteers, sub-contractors, 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 programs/classes. If I have any health or medical concerns now or after joining a class, I will discuss them with my doctor before attending & participating in any classes or using the Club/Studio"s services. Death/Disability Clause: 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. A refund of unused classes, MINUS a 15% administrative charge, can be provided upon withdrawal from any dance term EXCEPT in the cases where the fees paid or program purchased were purchased on sale or discounted - in this case all fee are FINAL SALE - no refunds will be issued I, the undersigned, waive and release the Club/Studio and its owners, shareholders, directors, volunteers, sub-contractors, employees, agents, representatives, successors and assigns from any and all claims in any way connected with my participation. 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 Club/Studio. I acknowledge that I am the legal guardian of the child(ren) listed on this form (if any). 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. *
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