I hereby consent my child(ren) participating in the program at Leslie's Dance Academy (LDA). I understand that injuries can occur and risk is involved
in dance activity that involves height and motion. I further agree the LDA, along with employees and officers of LDA, shall not be liable for any losses
or damages occuring as a result of my child('s) participation in dance, except where such loss or damage is the result of intentional or reckless conduct
of one of the individuals identified above. I allow LDA to publish photos of my child(ren) in any media form it deems fit.
I hereby certify that my child(ren) is(are) in good health and physical condition and is(are) able to participate in the LDA camp program
as well as maintain the physical condition to participate in the camp. This waiver and agreement, having been read thouroughly and understood completely
, is signed voluntarily as to its contents and intent.
FOR OFFICE USE ONLY: Total Cost $__________, Deposit Date___________, Amount of Deposit $_________, Form of Pay_________, Bal Due $__________,
Date Paid______________, Amount Paid $___________, Form of Pay________, Bal Due $___________.