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PACIFIC DANCE ACADEMY

Minor Release and Waiver of Liability

DROP OFF/PICK UP: I acknowledge that I am the parent and/or guardian of this/these children. I fully understand that the child(ren) must be dropped off and picked up by the same parent/guardian unless arranged otherwise in advanced. If there are any concerns or questions over guardianship, a picture ID will be required for pick-up and drop-off and a phone call made to the dropping off parent.

ILLNESS: I understand that if myself or my child(ren) become(s) ill during the course of the evening, I will be contacted and will immediately come and pick them up and/or I will be asked to leave class. Pacific Dance Academy and its employees are not responsible nor will they be held liable for student's illness.

EMERGENCIES: In the event of illness, accident or injury to you our your child(ren), Pacific Dance Academy employees will perform any minor emergency medical procedures necessary for your and your child(ren)’s safety until the guardian and/or emergency personnel can be presented. In the event of an emergency, I give Pacific Dance Academy and its employees the permission to contact 911 (Emergency Services) to aid in the care of myself and/or my child(ren). In the event of an emergency where evacuation of the studio becomes necessary, student's will be escorted to a secure area outside the premises at which time normal pick- up procedures can be followed. Our primary concern in such emergency situations is the safety and accountability of each child at all times.

BEHAVIORAL ISSUES: I understand that I, the guardian am responsible for the behavior of my child(ren). Uncontrollable or disrespectful behavior will not be tolerated. If my child(ren) behave(s) improperly, I will be contacted to pick-up my child immediately. Pacific Dance Academy employees shall have no responsibility for reprimanding or punishing children or correcting unruly or inappropriate behavior of children during the event.

MEDIA: I authorize Pacific Dance Academy to use and reproduce any photographs, audio, and/or video recording of myself or my child(ren) for advertising or marketing purposes and understand that neither I nor my child(ren) will receive any remuneration for such recordings.

MEDICATIONS: I understand that Pacific Dance Academy employees shall not be responsible for administering any (prescription or over-the-counter) medication.

EQUIPMENT: Other than normal wear and tear that occurs to the dance equipment in my child’s dance class, I understand that I am fully responsible for any damages myself or my child(ren) may incur on Pacific Dance Academy property including electronics, plumbing, furniture, fixtures, glass, etc.

CANCELLATIONs: Refunds may be subject to a 5% fee and are at the discretion of Pacific Dance Academy if requested 14 days or more prior to class start date. During instances of closures due to Covid-19 all classes will automatically continue online on the same day/time or be rescheduled. No refunds will be given. Missed classes will not be prorated due to absence. Exceptions may be made at the discretion of Pacific Dance Academy in cases of late enrollment or extended illness with a doctor's note. Make-ups will be scheduled based on teacher availability for closures due to weather realted events.

I do hereby waive, release and forever discharge Pacific Dance Academy and its employees from any and all claims and causes of action of any kind or nature which are in any way related, directly, or indirectly, to the use of Pacific Dance Academy which I may have or that hereafter may accrue including any such claims or causes of action caused in whole or in part by the negligence of Pacific Dance Academy and its employees. I further agree to indemnify, defend and hold harmless Pacific Dance Academy and its employees from any claims or causes of action of any kind arising from my or my child(ren)’s use of the dance studio.

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Please complete waiver before your first class of the season. 

Multiple students may be added to one waiver  if they have the same legal guardian.

To update your waiver, simply complete a new form. 

We send frequent email communications.

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Payment must be made online

or in-studio to reserve placement in class.

Completing waiver does not register you for class. 

8050 SE 13th AVE, STE 101  |  Portland, OR 97202  |  503.786.7197
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