Dance With Miranda Liability Form/Agreement

2010-2011

Payment Terms
I understand that dance classes start in August and end in May. If I ever choose to remove
my child, I will notify Miranda in order to end charges to my account. I agree to pay my
class tuition at the designated rate and agree to the following terms:

1. Class fees are due the first lesson of each month and are considered late after that
date.
2. A late fee of $5 will be added to the account if payment has not been received on
the first week of the month, and another $5 will be added monthly until the
balance is paid.
3. There will be a $25 fee for all returned checks.
4. In addition to regular class fees, there will be a recital fee of $10 per student.
5. There will be additional costs for recital including costumes, tights, accessories,
etc. Performance in the recital is not mandatory. You may choose to not
participate entirely or to participate in a limited amount of numbers. Once recital
costumes are paid for there are no refunds.

Release of Liability
I release Dance With Miranda and Miranda Cain from any or all liability whatsoever
while my child or any member of my family is at the studio or recital. I understand that,
as with any sport or physical activity, dancing includes the risk of injury and I will not
hold Miranda Cain, her teachers, assistants, or Dance With Miranda liable for medical
treatment of any injury that occurs in dance classes or at performances.
I have read the above and agree to the terms and release of liability for the 2010-2011
dance year.

Student Name:_______________________________________________
Parent/Guardian Signature:__________________________________ Date:___________