HEALTH QUESTIONNAIRE & STUDIO POLICIES
Personal information – So we can provide you with the best possible care and service, we ask that you carefully fill out the requested information. This information is kept strictly confidential and will be accessed by only your teacher(s).
How did you hear about Cadance Jazz & Pilates? *
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Which class(es) are you registering for? *
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How would you like to pay for class?
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CONTACT DETAILS
First and Last Name *
Telephone *
Email *
Emergency Contact Name (and relationship) & Telephone *
TELL US A BIT ABOUT YOURSELF
Briefly list your dance/performance or Pilates training/experience: *
Why do you want to take jazz dance/Pilates classes? *
Do you have an injuries or other limitations that may affect your movement in class? *
STUDIO POLICIES
PACKAGES & SESSIONS: • There are no refunds for missed classes; registered students may make up absences within the same session only.  There are no refunds once you have paid for the session or an à la carte package, unless for valid medical reasons.  A $20 withdrawal fee will apply. • À la carte packages are valid for six months from first use. They may not be transferred to another student, nor may classes remaining in the package be applied toward tuition for a session. • For session-registered Jazz, Pilates, Barre, or FitDance students who also have an À la carte package:  With at least 24-hours notice, you may make up your missed class by attending another group class within the same session.  With less than 24-hours notice of your absence, you forfeit the missed class. *
Required
PRIVATE CLASSES & SPECIAL PROJECTS: To avoid being charged for private/semi-private classes/choreography rehearsals not attended, you must provide a full 24-hours’ notice to cancel or change an appointment.  Cadance understands there may be unforeseen circumstances that may prevent you from attending your class/rehearsal.  However, this policy is vital for the good functioning of the classes/rehearsals and wait-listed students.  There are no exceptions to this policy. *
Required
STUDIO ETIQUETTE: Comfortable and form-fitting clothing allows the teacher to better assess posture and movement. Jazz shoes are ideal, but not required for jazz. During the pandemic, I will ask that you wear dance shoes or appropriate socks for your classes. NO OUTDOOR FOOTWEAR IS PERMITTED BEYOND THE STUDIO ENTRANCE. Kindly refrain from using heavy fragrances/perfumes, as other participants/teachers may have allergic reactions. Please set the ringer on your mobile phone to ‘mute’ or ‘vibrate’ prior to the start of your class so as not to disrupt the other students. Before each of your classes start, you will need to fill out the online COVID-19 Declaration. Please note that masks are required to attend class in studio, in addition to the other safety measures we’ll be following (hand hygiene, distancing, modified exercises/choreography). *
Required
PHOTOS/VIDEOS RELEASE: I understand that from time to time Rachel Santos/Cadance Jazz & Pilates may take photos or videos during class or other events. Rachel Santos/Cadance Jazz & Pilates has my permission to use these photos and videos on various promotional material including, but not limited to, Cadance's website, social media posts, and printed materials. ***If I do NOT consent to being photographed or video-recorded, I will be sure Rachel Santos is aware of my concerns. I will be proactive about avoiding being photographed or recorded and I will hold Rachel Santos/Cadance Jazz & Pilates harmless if a photo or video recording of me is released despite all precautions. I understand that this choice may limit my participation in choreography demonstrations that are routinely photographed and/or videotaped. *
Required
DECLARATION/WAIVER >>> I hereby declare the following: I understand that participation in Pilates, dance, and any other conditioning activity presents some unavoidable risk of injury, especially to people who have pre-existing injuries, illnesses, or medical disabilities. I understand that the use of exercise equipment also carries with it risk of injury. I understand a medical evaluation is advisable before starting any program of physical conditioning or exercise. I intend to keep Cadance Jazz & Pilates fully informed of any physical condition or disability which would prevent or limit my participation in an exercise or physical conditioning program. I acknowledge that neither Cadance Jazz & Pilates nor its employees are engaged in diagnosing or treating medical diseases or deficiencies. I expressly assume all risks of my participation in the programs conducted by Cadance Jazz & Pilates and its personnel as a result of personal injuries, property damage/loss, or wrongful death resulting from or relating to my participation in Pilates, dance, and fitness programs. (VIRTUAL CLASSES: I acknowledge that I am choosing to do Pilates/dance/workouts in my own space and I am assuming responsibility and liability for being aware of my surroundings and limitations, as well as screen sharing with others who have the ability to see me, and absolve Cadance Jazz & Pilates (Rachel Santos) of liability when using this service.) *
Required
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