Registration Form for Miramar's Danse Arabesque
Name: ________________________________________________________________
Address: _____________________________________________________________
City/State/Zip: _________________________________________________________
Phone(s): _____________________________________________________________
E-mail address: _________________________________________________________
Please print above very clearly as this is how I send out your notes.
Fill in below what you are registering for:
CLASS DAY/LEVEL: __________________________________________________
Or WORKSHOP: ___________________________________________________
Birth date- just the month & day ___________________________________________
By signing this, you agree that you have read and agreed to the Make-Up Policy, No Refunds for Missed Classes and Release.
Student Signature: ______________________________________________________
_____________________________________________________________________
Parent/Guardian Signature if student is under the age of 18
______________________________________________________________________
Miramar aka Esther Albright
NO REFUNDS FOR MISSED CLASSES
CLASS MAKE-UP POLICY: Students can make-up 2 missed classes per full-time paid session due to illness or family emergency. Please either phone (540) 888-4344 or send an e-mail to Miramar@visuallink.com. Requests for make-ups must be made within 48 hrs. from the absent student. Classes are to be made up during the current session. Missed class on the last night of a session can be made up during the following session provided you are enrolled full-time. Attend a make-up class at your level or lower and inform the instructor that you are making up a class upon your arrival.
RELEASE: In consideration of receiving permission from KRichard School of Dance, Inwood Performing Arts Co., Sportsplex and Miramar’s Danse Arabesque (Miramar’s) to use the premises of KRichard, Inwood Performing Arts Co., Sportsplex and Miramar’s. I hereby release KRichard, Inwood Performing Arts Co., Sportsplex and Miramar’s and their owners, agents, officers, servants and employees of and from any and all liability, claims, demands, actions and causes of action whatsoever, arising out of or related to any loss, damage or injury that may be sustained by me while in, or upon said premises and for me and heirs, devisees and assigns agree to hold KRichard, Inwood Performing Arts Co., Sportsplex and Miramar’s or its owners, agents, officers, servants and employees, including Esther Albright aka “Miramar”, free, clear and harmless of and from any and all such claims, demands, actions and causes of action whatsoever and to indemnify them of and from any and all such liability, claims, demands, actions and causes of action whatsoever as aforesaid, including attorney’s fees. I am duly aware of the risks and hazards inherent upon entering said premises and participating in said program and voluntarily assume all risks of loss, damage or injury, that may be sustained by me, while in, on or upon said premises or participating in any activity sponsored, in whole or in part, by KRichard, Inwood Performing Arts Co., Sportsplex and Miramar’s.