Consent To Electronic Signature
PLEASE READ THIS SECTION CAREFULLY! IF YOU DO NOT WISH TO CONSENT TO ELECTRONIC SIGNATURE, DO NOT PROCEED WITH THIS ONLINE REGISTRATION. PLEASE COME TO OUR DANCE STUDIO TO REGISTER IN-PERSON USING PAPER REGISTRATION.
This authorization concerns consent to communicate electronically in the submission of forms and documents related to enrollment and participation in Northern Lights Dance Academy ("NLDA") programs. If you are enrolling multiple participants, this consent is valid for all students enrolled.
In order to access and communicate electronically through this system, you will need to have a smartphone, tablet, or computer that can access and submit information through the Internet.
Please review the consent below and indicate if you are willing to communicate electronically on these matters by providing your electronic signature below.
If you consent to electronic communications but change your mind later, you may withdraw consent for further electronic communications by submitting written notice of your withdrawal by hand delivery to Kendal Ware or by U.S. mail addressed to Kendal Ware at Northern Lights Dance Academy, PO Box 192 Frazee, MN 56544. Your withdrawal shall be effective upon notice of receipt from Mrs Ware. Note that electronic communications, submissions, and signatures made prior to the date of withdrawal remain effective following withdrawal.
Your decision to decline or withdraw consent to electronic communications will have no impact on the enrollment of your student(s) at NLDA.
By checking the box below, you are: (1) consenting to communicate electronically with NLDA with regard to enrollment and participation in NLDA programs; (2) authorizing NLDA to send you notices, disclosures, and forms electronically, and agreeing that information and responses that you provide to NLDA may be stored in electronic format; and (3) agreeing that your electronic signature on an electronic authorization or agreement will serve the same purpose as a written signature.
I hereby release, indemnify and hold harmless Northern Lights Dance Academy, its owners, members, advisors and all employees from all liabilities, suits, claims, and/or demands of any kind or nature, legal or financial, whether caused in any way by the negligence or not, arising from the participation in or observation of any Northern Lights Dance Academy activity for injuries to any person or property, whether on or off the premises. The student/participant named does voluntarily participate in any and all Northern Lights Dance Academy activities and that the student/participant and I understand that certain risks are inherent to and from participation and involvement with Northern Lights Dance Academy and its various formal and informal activities. Northern Lights Dance Academy is not responsible for any lost or stolen property at any time. Anyone found to be violating the rules, codes of conduct, or found to be disruptive to either another individual or group may be asked to leave the premises or off-site location at any time and be refused re-entrance without any full or partial refund. Northern Lights Dance Academy does not carry medical insurance for its students and that is required that all dance students be covered by their own and/or family insurance policies and if harm and/or injury occurs it is understood that the students' own policy is their only source of reimbursement. I hereby authorize Northern Lights Dance Academy, its owners, and instructors to act for the student/participant named below according to their best judgement in providing or arranging for emergency care in any emergency circumstance requiring medical attention. I authorize the hospital, medical or care facility to dispose of any specimen or tissue during the course of any diagnosis, treatment or other normal and customary procedures. I understand that the facsimile or photocopy of this form with my signature on it is the same as an original.
SUMMER JUNE CLASSES: I understand that there are times where classes will be held outdoors. Dancers will be required to bring tennis shoes to these classes and will be spread out according to the CDC guidelines. There are no dancers allowed to sit and mingle in the lobby. All dancers will meet outdoors for the month of June. Please plan accordingly.
By registering online, you can sign up for e-payment and you are authorizing NLDA to use the account information for all of your account billing (including registration fee, tuition, costume fees, late fees, recital fees, and any other studio or dance related items purchased on account).
SUMMER DANCE: There must be a card on file that will be charged for summer dance class fees. The card will be charged each Friday of the weeks of summer dance.
By checking below, you agree to take full responsibility for payment of all charges and understand that a $15 late fee may be applied to your account if your credit card/bank account/check is declined and cannot be processed for the amount due at that time.
To discontinue enrollment in e-payment, you must notify Kendal in writing. Tuition is due by the 15th of the month, no later than the 15th, and can be paid via cash, credit/debit card, or check.
After the 15th of the month, a $15 late fee will be charged and enforced on all accounts past due, including e-payment accounts. Late notices will be sent via email. Tuition is not pro-rated for absences or studio closures. Students are encouraged to attend makeup classes for classes missed due to illness/vacation. There is a $25 return check charge.
For more information on fees and tuition please visit the Tuition page of our website located under the Classes menu.
Please note, there are no registration fees for summer classes.