25-26 Competition Company Audition Form
Please note: Audition Form is NOT complete until audition fee is received.
Payments can be made via Venmo, cash or check.
Audition Fee: $40 per dancer
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Dancer #1: Full Name & D.O.B. *
Classes available: *
Required
Dancer #2: Full Name & D.O.B.
Classes available:
Dancer #3: Full Name & D.O.B.
Classes available:
Home Address: *
Email Address: *
Parent's Full Name: *
Home Telephone: *
Cell Phone: *
Emergency Contact Name/Number (someone other than the parent listed above) *
Medical Information:
List any medical conditions and/or any physical conditions:
Previous dance experience *
Required
Previous Years Completed? If so where? *
Experience
PERMISSION TO USE STUDENT(S) PHOTOGRAPHS ONLINE *
Required
How did you hear about BPDS?
Referred by (BPDS student's name):
I agree that I am personally responsible for my safety and actions while taking classes at BPDS Fitness (Breaking Pointe Dance Studio, INC). I agree to comply with all BPDS policies and rules, including but not limited to all BPDS policies, guidelines, signage, and instructions. Because BPDS/Breaking Pointe Dance Studio, INC is open for use by other individuals, I recognize that I am at higher risk of contracting COVID-19.With full awareness and appreciation of the risks involved, I, for myself and on behalf of my family, spouse, estate, heirs, executors, administrators, assigns, and personal representatives, hereby forever release, waive, discharge, and covenant not to sue BPDS Fitness and/or Breaking Pointe Dance Studio, INC, its board members, officers, agents, servants, independent contractors, affiliates, employees, successors, and assigns (collectively the “Released Parties”) from any and all liability, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, or injury, including death, that may be sustained by me related to COVID-19 whether caused by the negligence of the Released Parties, any third-party attending classes at BPDS Fitness/Breaking Pointe Dance Studio, INC, or otherwise, while participating in any activity while in, on, or around BPDS and/or while using any BPDS facilities, tools, equipment, or materials.2. I agree to indemnify, defend, and hold harmless the Released Parties from and against any and all costs, expenses, damages, claims, lawsuits, judgments, losses, and/or liabilities (including attorney fees) arising either directly or indirectly from or related to any and all claims made by or against any of the Released Parties due to bodily injury, death, loss of use, monetary loss, or any other injury from or related to my use of BPDS facilities, tools, equipment, or materials, whether caused by the negligence of the Released Parties or otherwise specifically related to COVID-19.3. By signing below I acknowledge and represent that I have read the foregoing Waiver of Liability, understand it and sign it voluntarily as my own free act and deed, including without limitation the Release of Liability and Indemnification requirements contained in this document; I am sufficiently informed about the risks involved in taking classes at BPDS to decide whether to sign this document; no oral representations, statements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this document for full, adequate, and complete consideration fully intending to be bound by the same. I agree that this Wavier of Liability shall be governed by and construed in accordance with Massachusetts law, and that if any of the provisions hereof are found to be unenforceable, the remainder shall be enforced as fully as possible and the unenforceable provision(s) shall be deemed modified to the limited extent required to permit enforcement of the Wavier of Liability as a whole. This waiver remains in effect until the State of Massachusetts lifts all COVID-19 related mandates. *
By typing your name below: I understand that dancing can cause injuries that can be fatal. Breaking Pointe Dance Studio, INC is hereby released, forever discharged and not held liable for any injuries a student sustains during the course of classes. Along with the policies and procedures, I have read, understand  and agree to follow the registration agreement of Breaking Pointe Dance Studio, INC. *
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