Collective SC Pop Up Class Sign Up!
Wednesday March 4th at 7:30-9pm
Holy City Dance Center Clements Ferry Location l 1939 Clements Ferry Rd, Charleston, SC

Classes are geared towards intermediate/advanced adult dancers (high school dancers are welcome with parent permission).
 
Class Rate:
$15 Each ($10 for students)

*Non refundable, except in the event that the class is canceled by Collective SC.

Thank you so much!

Lacey Bates
Artistic Director
Collective SC
collectivescdance@gmail.com 
www.collectivescdance.com 
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Email *
Name *
Please Venmo @collectivescdance to complete your registration and secure your spot in class. Class is $15, $10 for students. *Non refundable, except in the event that the class is canceled by Collective SC. *
Required
Emergency Contact: (Name, Phone Number, and Relation)  *
Please list any medical conditions or injuries we should be aware of: 
Collective SC Liability and Image Release:

Client understands that there are risks of physical injury associated with, arising out of and inherent to the activity of dance. In recognition of this acknowledged risk of injury, Client knowingly and voluntarily waives all right and/or causes of action of any kind, including any and all claims of negligence arising as a result of such activity from which liability could accrue to Lacey Bates dba Collective SC, its officers, agents, employees, instructors, subsidiaries, parent corporations, and all affiliated entities. Client hereby agrees to release Lacey Bates dba Collective SC and hold them harmless of all liability, and hereby acknowledge that Client knowingly and voluntarily assumes full responsibility for all risks of physical injury arising out of active participation in dance. Client is aware that this is a release of liability and an acknowledgement of a voluntary and knowing assumption of the risk of injury. Client has signed this document voluntarily and freely in exchange for the privilege of participation.
 
Insurance and Indemnification. Client hereby expressly waives and discharges all claims and agrees to indemnify, defend and hold harmless Lacey Bates dba Collective SC from any injuries incurred during classes, rehearsals, or performances. Client also understands that the registration, tuition, and other fees (when applicable) must be paid and that Client will be held responsible for all fees. Lacey Bates dba Collective SC does not carry medical insurance for their Clients. All Clients are required to be covered by their own insurance policies. If injury occurs, it is understood that the Client’s own policy is their only source of reimbursement.
 
Image and Video Release. Client gives Lacey Bates dba Collective SC permission to use their picture and/or video in or on any form of advertisement for Lacey Bates dba Collective SC or an affiliated event.

Please sign your name below. (Parent signature required if under 18) *
Holy City Dance Center Liability and Image Release:

I agree to use Holy City Dance Center at my own risk. I agree to release and discharge Holy City Dance Center LLC, Hayley Zammuto, Audrey Sarbin and their successors, agents, and employees from all liabilities, claims, and demands that may result in my participation or my child's participation at Holy City Dance Center. I further acknowledge in signing this, I release all risk of injury to my person, my child(ren), and my property arising from participation at Holy City Dance Center and assume and are to pay all medical costs or property damage that may occur. I give my permission to
transport my child to the nearest hospital in case of an emergency. I acknowledge the contagious nature of COVID-19 and voluntarily assume all responsibility and risk that I or my child(ren) may be exposed to or infected by COVID-19 by participating and attending dance lessons at Holy City Dance Center. I Release, Waive, Discharge, Covenant Not To Sue Holy City Dance Center LLC, Hayley Zammuto, Audrey Sarbin and their successors, agents, and employees from any liability related to but not limited to exposure to COVID-19 or any other communicable disease or injury. I agree to not
send my child(ren) to Holy City Dance Center if they are sick or showing any flu like symptoms or signs such as but not limited to fever, cough, rash, or any of the symptoms related to COVID-19 or any contagious sickness or diseases.

I agree to allow Holy City Dance Center, LLC, Hayley Zammuto, Audrey Sarbin and all their successors, agents and employees rights to post all pictures,
and videos of myself and my child(ren) for use in social media advertisements as well as news papers, magazines, and any other form of advertisement
without any form of remuneration.

Please sign your name below. (Parent signature required if under 18) *
Disclaimer for Dancers Under 18
Please note that Collective SC is a professional adult contemporary dance company and classes are geared toward adults.
If the dancer is under the age of 18, a parent or legal guardian must acknowledge and understand that:
This class is not affiliated with Holy City Dance Center (HCDC) youth studio programming.
The content may include music with explicit language.
Classes are closed; observation by parents or outside parties is not permitted.
Participation is entirely voluntary, and by signing below, the parent/guardian consents to the dancer's participation under these terms.
A copy of your responses will be emailed to the address you provided.
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