top of page

Overnight Dance Camp Registration Form

CALVIN CREST, AUGUST 2nd - 8th, 2020

Please initial in each box.

Dates: August 2nd - August 8th, 2020

Payment: One Week Camp Session $915 per Camper

TERMS & CONDITIONS Overnight Camp 2020

I/We, as the parent or guardian and on behalf of my Camper, understand, acknowledge, and agree as follows:

  1. A $100 non-refundable deposit, per Camper, is due upon submission of each application. Applications received after 06/01/2020 must be paid in full at the time of submission of each application.

  2. ALL CAMP FEES ARE DUE IN FULL BY 06/01/2020. Failure to pay in full by 06/01/2020 will result in a $100 late fee per Camper.

  3. Cancellations made prior to 06/01/2020 will receive a full refund except a $100 non-refundable and non-transferable deposit per Camper. Cancellations made after 06/01/2020, 50% of camp fees are non-refundable and non-transferable per Camper. After 07/26/2020, all camp fees are non-refundable and non-transferable. All cancellations or changes to programs must be in writing.

  4. I/We understand that no refunds are given if, in its sole discretion, determines by the parents, that a child must leave camp for any reason.

* PLEASE FILL OUT ADDITIONAL HEALTH FORM BELOW. 

Fantasy Dance Studio Release, Waiver of Liability and Indemnity Agreement

Please read this form carefully before signing. In consideration of being permitted to participate, in any way, in the Fantasy Dance Studio's Program indicated below, and/ or be permitted to enter for any reason into the restricted area (herein defined as any area wherein admittance to the general public is prohibited). The student, parent(s) and/or legal guardian(s) of the minor participant named below agree:

​

1. The parent(s) and/or legal guardian(s) will instruct the minor participant that prior to participating in the below activity, or event, that he/she should inspect the facilities and equipment to be used. If he/she believes anything is unsafe, then the participant should immediately advise the officials of such condition, and from there, refuse to participate. I understand and agree that if at any time, I feel any conditions to be UNSAFE, I will immediately take all precautions to avoid any unsafe area, and therefore REFUSE TO PARTICIPATE further. 

2. I/WE fully understand and acknowledge that:

(a) There are risks and dangers associated with any participation in Dance Events and Activities. Any of which could result in bodily injury, partial and/or total disability, paralysis, and death.

(b) The social and economic losses and/or damages that could result from these risks and dangers described above could be severe.

(c) The action may cause these risks and dangers, inaction, or negligence of the participant, or the action, inaction or negligence of others including, but not limited to, the Releasees named below.

(d) There may be other risks not known to us or are not reasonably foreseeable at this time.

3. I/WE accept and assume such risks and responsibility for the losses and/or damages following such injury, disability, paralysis, or death however caused, and whether caused either in whole or in part, by the negligence of the Releasees named below. 

4. I/WE HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the dance facility used by the participant including its owners, managers, promoters, lessees of the premises used to conduct the dance event or program, premises and event inspectors, underwriters, consultants, and others who give recommendations, direction, or instructions to engage in risk evaluation or loss control activities regarding the dance facility, or events held at such facility. This includes their directors, officers, agents, employees all for the purposes herein referred to as "Release" FROM ALL LIABILITY TO THE UNDERSIGNED, my/our personal representatives, assign, executors, heirs and next of him FOR ANY, AND ALL CLAIMS, DEMANDS, LOSSES OR DAMAGES. INCLUDING ANY, AND ALL CLAIMS THEREFORE ON ACCOUNT OF ANY INJURY INCLUDING, BUT NOT LIMITED TO, THE DEATH OF THE PARTICIPANT OR DAMAGE TO THE PROPERTY ARISING OUT OF, OR RELATING TO THE EVENT(S) CAUSED, OR ALLEGEDLY CAUSED IN WHOLE, OR IN PART BY THE NEGLIGENCE OF THE RELEASE OR OTHERWISE.

5. I/WE HEREBY acknowledge that THE ACTIVITIES OF THE EVENT(S) ARE VERY DANGEROUS and involve the risk of serious injury and/or death and/or property damage. Each of THE UNDERSIGNED also expressly acknowledges that INJURIES RECEIVED MAY BE COMPOUNDED, OR INCREASED BY THE NEGLIGENT RESCUE OPERATIONS OR PROCEDURES OF THE RELEASES.

6. EACH OF THE UNDERSIGNED further expressly agrees that the foregoing release, waiver, and indemnity agreement is intended to be as broad and as inclusive as is permitted by the Law of the Province or State in which the event is conducted. If any portion is held invalid, it is agreed that the balance shall notwithstanding continue in full legal force and effect.

7. On behalf of the participant, and individually the undersigned parent(s) and/or legal guardian(s) for the minor participant makes a claim against any of the Releases, execute this Waiver and Release. If, despite this release, the participant makes a claim against any of the Releases, the parent(s) and/or legal guardian(s) will reimburse the Releases for any money which they have paid to the participant, or on his behalf, and hold themselves harmless.

HEALTH & MEDICAL RELEASE FORM

 

2500 Old Middlefield Way, Mountain View, CA 94043

(650) 965-4135

www.FantasyDance.us

info@fantasydance.us

​

Camp Grounds: Calvin Crest      

Camp Dates: August 2nd - 8th, 2020

What to do with this form?

> To be completed by camper or if under 18 years of age, the parent or legal guardian.

> Camper will be RESTRICTED from all physical activities until completed Health History with insurance information on file.

Camper 1

Insurance Information

 

COMPLETE Information Required for emergency

The prescription must be sent in their original bottle/packaging with the label and Camper's Name on it. 

Camper 2

Insurance Information

 

COMPLETE Information Required for emergency

The prescription must be sent in their original bottle/packaging with the label and Camper's Name on it. 

Medical Liability Release

 

MEDICAL RELEASE: This health history is correct so far as I know and this person has the permission of the undersigned to engage in all camp activities except as noted. In case of illness or injury, Fantasy Dance Studio has my permission to procure medical treatment for the above named (minor, if applicable). I understand Fantasy Dance Studio does not provide medical insurance or reimbursement for medical fees or prescriptions and that I am responsible for any / all such fees and charges arising from illness or injury that may occur.

​

LIABILITY RELEASE: The undersigned, for himself or herself and on behalf of his or her child(ren) or ward(s) and their personal representatives as-signs or heirs, hereby releases and agrees and covenants not to sue Fantasy Dance Studio, their owners, directors, stockholders, agents, successors, or any employee, from any and all liability for loss, damage, injury, death, or any other claim whatever to the person or property of any guest or participant whether caused by negligence of Releasees or any other person or thing while participating in activities sponsored by or associated with Fantasy Dance Studio. The undersigned elects to participate and / or allow his or her child(ren), ward(s), to participate voluntarily and assumes all risk of loss, damage, injury or death, known or unknown, foreseen or unforeseen, that may be sustained.

​

YOU HAVE THE OPTION NOT TO PARTICIPATE OR ALLOW YOUR CHILD, CHILDREN, WARD OR WARDS NOT TO PARTICIPATE IN ANY ACTIVITY WHERE YOU DO NOT WISH TO WAIVE LIABILITY. IT SHALL BE YOUR RESPONSIBILITY TO ENSURE THAT YOUR CHILD, CHILDREN, WARD OR WARDS DO(ES) NOT PARTICIPATE IN THE ACTIVITIES FOR WHICH YOU CHOOSE NOT TO BEAR LIABILITY.

​

The undersigned has read and voluntarily signs this medical release and waiver of all liability.

Thanks for submitting!

bottom of page