2022 FREE In-Person Dance Intensive Registration Form
K.S. J.A.M.M. Dance Troupe’s FREE Dance Intensive is for students in Pre-Kindergarten through 12th grade.

The Dance Intensive is designed for students new to dance and students who’ve taken classes throughout the school year to promote physical and mental health, as well as building a healthier immune system. Each session will provide students with an energetic, motivational and fun program that combines learning new choreography while working on flexibility, stretching and technique in Ballet, African and Hip Hop.

As an extension to the academic classroom, students will learn terms and techniques through lessons, demonstration and execution of choreography. Lessons are developed using the New York City Department of Education’s Blue Print curriculum, which provides a standards-based rigorous approach to teaching the arts.

First come first serve. Each level is limited to 15 students
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電子郵件 *
Parent/Guardian's First Name, Last Name *
Parent/Guardian's Email Address *
Parent/Guardian's Cell Phone *
Student #1 First Name, Last Name *
Student #1 Level & Sessions (PLEASE SELECT ONLY THE SESSIONS APPROPRIATE FOR YOUR CHILD'S AGE) *
必填
Student #2 First Name, Last Name
Student #2 Level & Sessions (PLEASE SELECT ONLY THE SESSIONS APPROPRIATE FOR YOUR CHILD'S AGE)
Student #3 First Name, Last Name
Student #3 Level & Sessions (PLEASE SELECT ONLY THE SESSIONS APPROPRIATE FOR YOUR CHILD'S AGE)
Individuals 18 years old & older authorized to pick up your child/children *
STUDENT WAIVER AND LIABILITY RELEASE - I hereby release, indemnify and hold harmless K.S. J.A.M.M. Dance Troupe, Inc., New York City Department of Education, 347 Nostrand Avenue, and its owners, members, advisors, Board of Directors, and all employees and agents of these parties from all liabilities, suits, claims. and/or demands of any kind or nature, legal or financial, whether caused in any way by the negligence or not, arising from the participation in or observation of any K.S. J.A.M.M. Dance Troupe, Inc. activity for injuries to any person or property, whether on or off the premises. The student/participant named below does voluntarily participate in any and K.S. J.A.M.M. Dance Troupe, Inc. activities and that the student/participant and I understand that certain risks are inherent to and from participation and involvement with K.S. J.A.M.M. Dance Troupe, Inc. and in its various formal and informal activities. These activities include but are not limited to Dance.  K.S. J.A.M.M. Dance Troupe, Inc. is not responsible for any lost or stolen property, at any time. Anyone found to be violating any of the rules, codes of conduct, or found to be disruptive to either another individual or group may be asked to leave the premises or off-site location at any time and be refused reentrance without any full or partial refund. *
必填
MEDICAL RELEASE - As the parent/legal guardian of the student/participant named below, I request and authorize that in my absence the student/participant named below be admitted to any hospital or medical facility for diagnosis and treatment. I request and authorize physicians, dentists, and staff, duly licensed as Doctors of Medicine/Osteopathy or Doctors of Dentistry or other such licensed technicians or nurses, to perform any diagnostic procedures, treatment procedures, operative procedures and x-ray treatment of the student/participant named below. I have not been given any guarantee as to the results of examination or treatment. I hereby authorize K.S. J.A.M.M. Dance Troupe, Inc., its owners, members, Board of Directors, and all employees and agents of these parties to act for the student/participant named below according to their best judgment in providing or arranging for emergency care in any emergency circumstance requiring medical attention. I authorize the hospital, medical or care facility to dispose of any specimen or tissue during the course of any diagnosis, treatment or other normal and customary *
必填
MEDICAL RELEASE - I represent that I understand the nature of this activity and that I am qualified, in good health and in proper physical condition to participate in such activity. I acknowledge that if I believe event conditions are unsafe or I am unable to safely perform any activity, I will immediately discontinue participation in the activity. *
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MEDICAL RELEASE - I fully acknowledge, understand, appreciate and agree, that this activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the Releasees named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, cost, and damages I incur as a result of my participation in the activity. *
必填
MEDICAL RELEASE - I further acknowledge, understand, appreciate and agree that my participation may result in 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. 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 exposure. *
必填
I hereby release, discharge, and covenant not to sue your business, it's administrators, directors, agents, officers, volunteers, employees, contractors, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of the premises on which the activity takes place, (each considered one of the “RELEASEES” herein) from all liability, claims, demands, losses, damages, on my account caused or alleged to be caused in whole or in party by the negligence of the RELEASEES or otherwise, including negligent rescue operations and further agree that if, despite this release, waiver of liability, and assumption of risk, I or anyone on my behalf, makes a claim against any of the RELEASEES, I will indemnify, defend, and hold harmless each of the RELEASEES from any loss, liability, damage, or cost, which any may incur as the result of such a claim. *
必填
I have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, and I understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law. I agree that if any portion of this Agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect. *
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PARENTAL CONSENT I, hereby covenant and promise that I am the minor’s parent and/or legal guardian, and on behalf of myself and the minor, understand the nature of the above referenced activities and the minor’s experience and capabilities and believe the minor to be qualified to participate in such activity. I further understand the risk of exposure to injury and/or infectious diseases, for myself and my child, as a participant, spectator at events, classes or our presence at the facility. I hereby release, discharge, covenant not to sue and AGREE TO DEFEND, INDEMNIFY AND HOLD HARMLESS each of the RELEASEES from all liability, claims, demands, losses or damages on the minor’s or my account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, including, but not limited to injury, negligent rescue operations, and/or exposure to infectious diseases and I further agree that if, despite this release, I, the minor, or anyone on the minor’s behalf makes a claim against any of the above RELEASEES, I WILL DEFEND, INDEMNIFY, AND HOLD HARMLESS each of the RELEASEES from any litigation expenses, attorney fees, loss liability, damage, or cost which any RELEASEE may incur as the result of any such claim. *
必填
PHOTO AND VIDEO IMAGING RELEASE - I hereby understand and am fully aware that the student/participant named below may be participating in K.S. J.A.M.M. Dance Troupe, Inc. activities in which I and/or the student/participant named below may be photographed or videotaped (the Property) from time to time. I hereby irrevocably grant to K.S. J.A.M.M. Dance Troupe, Inc. perpetually, exclusively, and for all media throughout the world (including print, non theatrical, home video, CD-ROM, internet and any other electronic medium presently in existence or invented in the future), the right to use and incorporate (alone or together with other materials), in whole or in part, photographs, sound bites or video footage taken as a result of participation in K.S. J.A.M.M. Dance Troupe, Inc. activities. I hereby agree that I will not bring or consent to others bringing claim or action against K.S. J.A.M.M. Dance Troupe, Inc. on the grounds that anything contained in the Property, or in the advertising and publicity used in connection herewith, is defamatory, reflects adversely on me or the student/participant named below, violates any other right whatsoever, including, without limitation, rights of privacy and publicity. I hereby release K.S. J.A.M.M. Dance Troupe, Inc., its owners, members, Board of Directors, and all employees and agents of these parties from and against any and all claims, demands, actions, causes of actions, suits, costs, expenses, liabilities, and damages whatsoever that I may hereafter have against K.S. J.A.M.M. Dance Troupe, Inc. in connection with the Property. This agreement shall not obligate K.S. J.A.M.M. Dance Troupe, Inc. to use the Property or to use any of the rights granted hereunder, or to prepare, produce, exhibit, distribute or exploit the Property. K.S. J.A.M.M. Dance Troupe, Inc. shall have the right to assign its rights hereunder, without my consent, in whole or in part, to any person, firm, corporation or organization. *
必填
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