Fall 2024 Tiny Tots Session

2024 Fall Tiny Tots Session

Please fill in the form below. There is no payment required at the time of your submission. Your registration reserves a space in the class for your dancer for 48 hours. We will contact you with your tuition breakdown and payment options before processing your first payment.
Ajax Dance Company: Participation Waiver, Photo/Video Release & Acknowledgement, Online & Virtual Dance Class Waiver

Please fill in the form below, every participant is required to fill out the information below before they are able to begin taking class at Ajax Dance Company.
Participants Full Name
Name*

First NameLast Name
Birth date *

MonthDayYear
Dancer must be TWO by Oct 1/2023
Gender*

FemaleMaleOther
Participants Health Card #*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
please use the email you would like the meeting codes to be sent to
Parent/Guardian Information #1
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Relationship to participant*
Parent/Guardian Information #2
Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship to participant
Emergency Contact Information
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Relationship to participant*
Please list any health concerns or information regarding your participant that our staff should be notified of:*
How did you hear about us? *
Please indicate what class/classes you would like your dancer to participate in.
All classes are listed by day of the week.

There is no payment required upon submission of this online form. A quote, with all applicable discounts, will be sent to you with with your payment options. Once you have confirmed your prefered payment method, an active invoice will follow for your review before providing payment.
Please select your class of choice below

Tiny Tots (7 weeks) -- Saturday October 19 - November 30 @ 9:00-9:30AMTiny Tots (7 weeks) -- Wednesday October 16 - November 27 @ 4:15-4:45PM
For information on class pricing please submit this form for a quote on your class selection(s) OR contact the studio (ajaxdanceco@hotmail.com) for a tution fee schedule.

A MINIMUM OF 3-4 DANCERS PER CLASS IS NEEDED FOR A CLASS TO RUN. This schedule is TENTATIVE and subject to change at any time. We reserve the right to combine, cancel, or add classes to accommodate enrollment. Ajax Dance Company will always do the absolute best to accommodate the majority of the class if changes in the schedule are needed/altered. Class placement is based on many factors including dances capabilities, maturity, and previous experience. Placement is made with the best interest of the student in mind.
Participation Waiver:
I am aware that the participation of myself/my child in dance, acrobatic dance, and barre fitness involves inherent risk and hazards. I understand that the activity that myself/my child is participating in is a barre fitness, dance, or acrobatic dance class. I freely accept and fully assume (on behalf of myself or my son/daughter) all such risks, dangers, and hazards and the possibility of injury, property damage, or loss resulting from such risks and hazards.

I voluntarily agree to release Ajax Dance Company from any and all liability for any loss, damage, illness, injury or expense that myself or my child may suffer or incur as a result of participation in barre fitness, dance, and acrobatic dance lessons, including negligence on the part of Ajax Dance Company, it’s owner, staff, and/or contractors.

As the Parent or Guardian of the above stated participant, if I cannot be contacted, I authorize Ajax Dance Company to seek medical services in case of serious injury or illness. I further agree to accept financial responsibility in excess of the benefits allowed by my health plan.

I understand that Ajax Dance Company employees and/or its contractors will not assume responsibility for any lost or stolen property, or for any bodily or personal injury consisting of or arising out of any participation in any physical training or athletic activity.
As the Parent/Guardian of the Participant or the Participant (18 years or older):*

Agree, and fully consent to the participation waiverDisagree, and do not consent to the Participation Waiver
Photo & Video Release and Acknowledgement & Agreement:
I herby acknowledge that all right, title, and interest in video(s) and/or photograph(s) in which myself/my child has participated, being original works, belong to “Ajax Dance Company” and that the said video(s) and/or photograph(s), its titles and all other constituents were prepared under the direction or control of “Ajax Dance Company”. I hereby release “Ajax Dance Company” from all claims, which I may have now or in future, for compensation of any kind arising out of myself/my child’s participation in the said video(s) and/or photography(s) and acknowledge that “Ajax Dance Company” may use the video(s) and/or photograph(s) in social media, advertising, and archiving. “Ajax Dance Company” may choose not to use any of the video(s) and/or photography(s) at this time, but may do so at its own discretion at a later date. “Ajax Dance Company” reserves the right to discontinue use of video(s) and/or photography(s) without notice.

I acknowledge that I have carefully read this agreement and that I agree to conform and comply with this agreement in its entirety, that I have executed it voluntarily and that this agreement is binding. I consent to and authorize that use by “Ajax Dance Company”, or anyone authorized by “Ajax Dance Company” (including associates, employees, agents, or representatives), of any and all video(s) and/or photography(s) that have been taken of my child/children.
As the Parent/Guardian of the Participant or the Participant (18 years or older):*

Agree, and fully consent to the Photo & Video Release and Acknowledgement & Agreement.Disagree, and do not give my consent for my participants image to be used for any photography or videography to be used by Ajax Dance Company. I understand this will mean my dancer dancer will not be featured in the end of year slide show presented at recital or be able to take a group photo with other dancers in their class during photo day.
Confirmation:

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE AND IS APPLICABLE TO THE ABOVE STATED PARTICIPATION WAIVER AND PHOTOGRAPHY & VIDEO RELEASE AGREEMENT. THIS SIGNATURE CONFIRMS THAT THE EMERGENCY CONTACT INFORMATION IS ACCURATE AND TO BE USED IN THE EVENT OF AN EMERGENCY. I HAVE READ AND UNDERSTAND THE POLICIES AND PROCEDURES ATTACHED TO THIS REGISTRATION FORM.
Signature*

Clear
Thank you for your registration with Ajax Dance Company! You will receive a confirmation email with fees and payment options within 48 hours.

We are looking forward to dancing through the fall with you!

Should you have any further questions please email us at ajaxdanceco@hotmail.com
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2024 Fall Tiny Tots Session

Participants Full Name

Parent/Guardian Information #1

Parent/Guardian Information #2

Emergency Contact Information

Participation Waiver:

Photo & Video Release and Acknowledgement & Agreement: