New Student Information
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Email *
Student Name *
Student Date of Birth *
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Gender *
Age *
Parent/Guardian Name *
Parent/Guardian Relationship  *
Parent/Guardian Phone Number *
Address *
Trial Date: *
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Classes Interested in: *
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I acknowledge that by signing this form, I will enroll my child in the 2022-2023 dance season
with MotionScoop Dance Academy (MotionScoop Dance Corp.). I understand that tuition
payments are due on the first of each month and that the tuition amounts are adjusted with
holidays and emergency snow days throughout the year. I understand that attendance is
mandatory for our training program and, if need to be absent, I will work with the teacher to
make up the missing material as they see fit. Furthermore, I acknowledge that MotionScoop
Dance Academy has a uniform dress code that has been given to me, I will follow all
guidelines as instructed. Finally, I will ensure to stay up-to-date with any studio updates by
visiting our Parent Portal and regularly reading all emails/newsletters that are sent my way.
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I acknowledge that this Accident Waiver and Release of Liability Form will be used by the
venues, event holders, sponsors, and organizers of the activity in which me or my child may
participate and that it will govern my actions and responsibilities at any event with
MotionScoop Dance Corp. In consideration of my application and permitting me to participate
in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin,
successors, and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my disability, personal
injury, property damage, property theft, or actions of any kind which may hereafter occur to me
including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS:
MotionScoop Dance Corp., and/or their directors, officers, employees, volunteers, representatives,
and agents, and the activity holders, sponsors, and volunteers.
(B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this
paragraph from any and all liabilities or claims made as a result of participation in this activity,
whether caused by the negligence of release or otherwise. I acknowledge that volunteers,
substitutes, employees, teachers, and students with MotionScoop Dance Corp., and their
affiliates, directors, officers, volunteers, representatives, and agents are NOT responsible for the
errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on
their behalf. I hereby consent to receive medical treatment which may be deemed advisable in
the event of injury, accident, and/or illness during this activity.
(C) PHOTOGRAPHY RELEASE: I understand while participating in this activity both my child and I
may be photographed. I agree to allow our photo, video, or film likeness to be used for any
legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns including
but not limited to social media posts, marketing materials, company websites, newsletters, and
email campaigns.
The Waiver and Release Form shall be construed broadly to provide a release and waiver to
the maximum extent permissible under applicable laws by the State of New York.
I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE
THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT. I ACKNOWLEDGE THAT I SIGN IT OF MY OWN
FREE WILL.
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