Lakes Region Dance Registration
2022 SUMMER DANCE

There will be a $25 registration fee and all tuition and registration fees will be invoiced.
  • Student Information:

  • Family Information:

  • Video/Photo Release

    Lakes Region Dance is hereby granted permission to take photographs or videos of our students to use in brochures, websites, posters, advertisements, social media and other promotional materials that LRD may create.
  • Release and Waiver of Liability and Protection Agreement

    Physical activities such as dance and tumbling carry a risk of injury to students. I hereby release Lakes Region Dance of any liability whatsoever arising out of an injury, damage or loss which may be sustained by said person during the course of involvement with Lakes Region Dance. This includes classes held in the dance studio and during any other dance performance or rehearsal with Lakes Region Dance. I have read this waiver agreement, understand its contents, and accept and assume such risks.
  • COVID WAIVERS

    Please review the COVID waiver that pertains to you or your registrant and check the box below accordingly.
  • COIVD Waiver for Minors Registering

    Minor Participant Waiver, Release, Indemnification of All Claims & Covenant Not to Sue

    PLEASE READ CAREFULLY. THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS AND IS
    LEGALLY BINDING. BY SIGNING THIS AGREEMENT YOU ARE RELEASING LAKES REGION DANCE FROM ALL LIABILITY AND FOREVER GIVING UP ANY CLAIMS THEREFORE

    Assumption of Risk

    I, in my legal capacity as the parent/guardian of the minor named below (“Minor”), acknowledge and agree that any use of Lakes Region Dance facilities, services, equipment and premises (“Facilities”) and any participation in Lakes Region Dance programs and activities (“Programs”) comes with inherent risks including, but in no way limited to: (1) moderate and severe personal injury, (2) property damage, (3) disability, (4) death, and (5) sickness or disease. I voluntarily, for myself and Minor, accept and assume full responsibility for these risks as well as any and all other risks of the use of Facilities and participation in Programs. I agree that I have full knowledge of the nature and extent of all such risks and am not relying on all such risks being described in this document.

    Waiver, Release, Indemnification & Covenant Not to Sue

    In consideration of Minor’s use of Facilities and participation in Programs I, in my legal capacity as parent/guardian of Minor, agree on behalf of myself and Minor that Lakes Region Dance, it’s officers, directors, agents, employees, volunteers, insurers and representatives (“Releasees”) will not be liable for any personal injury, property damage, disability, death, sickness or disease incurred by Minor, however occurring including, but not limited to, the negligence of Releasees. I understand that Minor and I will be solely responsible for any loss or damage, including personal injury, property damage, disability, death, sickness or death sustained from the use of Facilities and participation in Programs.

    I further agree, in my legal capacity as the parent/guardian of Minor, on behalf of Minor, myself, and any and all legal successors and proxies, to release and HEREBY DO RELEASE, WAIVE AND COVENANT NOT TO SUE Releasees from any causes of action, claims, suits, liabilities or demands of any nature whatsoever including, but in no way limited to, claims of negligence, which Minor, myself, and any and all legal successors and proxies may have, now or in the future, against Releasees on account of personal injury, property damage, disability, death, sickness, disease or accident of any kind, arising out of or in any way related to the use of Facilities or participation in Programs, whether that participation is supervised or unsupervised, however the injury or damage occurs, including, but not limited to, the negligence of Releasees.

    In further consideration of the use of Facilities and participation in Programs, I, in my legal capacity as parent/guardian of Minor, agree on behalf of myself and Minor to INDEMNIFY AND HOLD HARMLESS Releasees from any and all causes of action, claims, demands, losses, suits, liabilities or costs of any nature whatsoever, including claims of negligence, arising out of or in any way related to the use of Facilities and participation in Programs.
  • COIVD Waiver for Adults Registering

    Adult Participant Release & Waiver of Liability and Indemnity Agreement

    PLEASE READ CAREFULLY. THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS AND IS LEGALLY BINDING. BY SIGNING THIS AGREEMENT YOU ARE RELEASING LAKES REGION DANCE FROM ALL LIABILITY AND FOREVER GIVING UP ANY CLAIMS THEREFORE

    Assumption of Risk

    I acknowledge and agree that any use of Lakes Region Dance facilities, services, equipment and premises (“Facilities”) and any participation in Lakes Region Dance programs and activities (“Programs”) comes with inherent risks including, but in no way limited to: (1) moderate and severe personal injury, (2) property damage, (3) disability, (4) death, and (5) sickness or disease. I voluntarily accept and assume full responsibility for these risks as well as any and all other risks of the use of Facilities and participation in Programs. I agree that I have full knowledge of the nature and extent of all such risks and am not relying on all such risks being described in this document.

    Waiver, Release, Indemnification & Covenant Not to Sue

    In consideration of the use of Facilities and participation in Programs I, the undersigned, agree that Lakes Region Dance, it’s officers, directors, agents, employees, volunteers, insurers and representatives (“Releasees”) will not be liable for any personal injury, property damage, disability, death, sickness or disease incurred by myself, my family members, dependents, or guests, including minors, however occurring including, but not limited to the negligence of Releasees. I understand that I will be solely responsible for any loss or damage, including personal injury, property damage, disability, death, sickness or disease sustained from the use of Facilities and participation in Programs.

    I further agree, on behalf of myself and any and all legal successors and proxies, to release and HEREBY DO RELEASE, WAIVE AND COVENANT NOT TO SUE Releasees from any causes of action, claims, suits, liabilities or demands of any nature whatsoever including, but in no way limited to, claims of negligence, which I and any and all legal successors and proxies may have, now or in the future, against Releasees on account of personal injury, property damage, disability, death, sickness, diseases or accident of any kind, arising out of or in any way related to the use of Facilities or participation in Programs, whether that participation is supervised or unsupervised, however the injury or damage occurs, including, but not limited to the negligence of Releasees.

    In further consideration of the use of Facilities and participation in Programs, I agree to INDEMNIFY AND HOLD HARMLESS Releasees from any and all causes of action, claims, demands, losses, suits, liabilities or costs of any nature whatsoever, including claims of negligence, arising out of or in any way related to the use of Facilities and participation in Programs by myself, my family members, dependents or guests, including any minors.
  • *** If your monthly tuition payment is NOT paid by the 1st of each month than a $25 late fee will be added to your account.

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