Express After School Program
Welcome to Express after School with Expressions in Rhythm Studio! We are a family owned business born out of a love for the arts with a dedication to serving our community.
Today's Date *
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Express After School Program Location *
Child's Name *
Your answer
Date of Birth *
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Grade *
Your answer
Parent/Guardian's Name *
Your answer
Relationship to child *
Your answer
Best Contact Number (Please include the area code) *
Your answer
E-mail Address *
Your answer
Express After School Program *
Previous Dance/Drum Experience? *
If you answered yes to previous dance/drum experience, please state where and when.
Your answer
Medical Concerns/Allergies/Disabilities/Other *
Your answer
Assumption of Risk & Release of Liability- Please initial below *
I understand and acknowledge there is a risk of injury inherent in activities at the Studio and that personal injury and/or damage to property may result during participation in the Studio classes. I acknowledge that the Student is physically able to safely participate in the classes selected. I give permission for the Student to perform stunts, aerials, lifts or other activities, related to their respective class, at the Studio and in any and all performances. Account Holder agrees to assume all risk associated with the Student's participation in instruction, rehearsal, performance, and related activities. In consideration of receiving instruction at the Studio, I hereby waive, release and discharge the Studio, its officers, directors, employees, agents, successors, sponsors, legal representatives and assigns, from all present and future claims and liabilities of any kind, whether for bodily injury, property damage, or other loss of Student or Account Holder arising out of participation in Studio classes whether conducted on or off Studio premises.
Your answer
Express After School Program Fees- Please initial below *
I understand and acknowledge that Express After School Program fees are due the first (1st) of each month. I acknowledge if the fees are not paid by the fifth (5th) of each month, Expressions in Rhythm Studio will charge a $5 fee to my Express After School Program account. If all fees are not paid by the tenth (10th) of each month, my child may not participate in the Express After School Program. If I am untruthful about payments and send my child to the Express After School Program without paying the tuition fee, my child will no longer be allowed to participate in the Express After School Program.
Your answer
I have read and understand the Express After School Program guidelines and agree to abide by said policies. *
Please initial below
Your answer
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