Name of Child/Participant *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Name of Guardian

If Participant is Under 18 Years of Age

First Name

Last Name

Cell Phone *

(###)

###

####

Emergency Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Select Class

Mixed Media ArtShop 6 MON.4/22-6/10 4:15-5:15PM $130.

Theater of Myths &Tales 7 TUES.4/23-6/4 4:15-5:15PM $150.

Fairytale Theater 7 WED. 4/24-6/5 4:15-5:15PM $150.

Sun Yoga

PLAYSHOP: YogArt 8/10 2-3:15PM $25.or $40. for 2 children

BIRTHDAY PARTY HOST

Creative Dance 6 FRI. 4/26-5/31 4:15-5:15PM $130.

JR.Playwrights 7 THURS. 4/25-June 6 4:15-5:15pm $150.

Release of Liability *

I do hereby release from liability Sunnyfield Studio/Melissa Duda for any injuries, in the event they should be sustained during the course of dance study at Sunnyfield Studio.

I understand

Photography Release *

Permission to use class photos and/or video for promotion?

Yes

No

Sunnyfield Studio Waiver of Liability

ASSUMPTION OF THE RISKS: I understand that COVID-19 may exist in the community, including at Sunnyfield Studio, and presents an inherent risk that cannot be eliminated. I acknowledge that, although Sunnyfield Studio is taking reasonable measures to avoid contact, transmittal, and exposure of disease processes like COVID-19, but not limited to, between people in our classes (including Melissa Duda and third parties), it is ultimately my responsibility to ensure that I and my child take appropriate actions to safe-guard ourselves. I do hereby release Sunnyfield Studio/Melissa Duda for any injuries or exposure to any communicable disease, including but not limited to COVID-19, in the event they should be sustained during the course of study at Sunnyfield Studio. I also assume the inherent risk of being outdoors, including but not limited to ticks, bees, poison ivy, etc. The claims hereby released include but are not limited to, claims of negligence against any of the released parties. I HAVE CAREFULLY READ THIS WAIVER AND FULLY UNDERSTAND ITS CONTENTS. BY ENROLLING IN CLASSES AT SUNNYFIELD STUDIO, I UNDERSTAND I HAVE GIVEN UP MY RIGHTS AND THIS IS A BINDING LEGAL DOCUMENT.

I have read and agree