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Class Location: SEMESTER
II Semester II
MEMBERSHIP Name of FirstClass: ___________________________________________________ Day and Time of Class:_________________________________________________ Name of Second Class: ________________________________________________ Would like to do a Membership? Please initial: ________________________________ *E-mail: (Must be up to date and filled in for registration to be complete)_____________ Parent's Phone:____________ Cell Phone:____________ Emergency No.:__________ Address:_____________________________________________________________ *Credit Card: (Must be up to date and filled in for registration
to be complete) Expiration Date:________________________________________________________ Child?s Name:__________________________________________________________ Child?s Age:________________________ Child?s Birthday:___#/#/##______________ Caregiver?s Name:______________________________________________________ Caregiver?s Phone:______________________________________________________ How did you hear of DramaZone? (Please circle) Parent Guide Magazine -- Website -- Big Apple Parent Magazine -- GoCityKids.com -- Flyer -- Friend -- DramaZone Teacher_______________________ Other_________________________________ Discounts: 10% off Semester II till Dec. 20, 2007 Total $________ Please read and sign the below enrollment agreement form, send with your registration form and check to be mailed to our corporate offices: DramaZone 377 Park Avenue South Ground Fl. New York, NYC 10016 Your cancelled check is your receipt. Thank you for choosing a DramaZone Class. Inquire about DramaZone Birthday Parties and Summer Camp! DramaZone Ltd. Enrollment Agreement Child?s Name:________________________________________________________________ 1. The undersigned parent or guardian (Parent) of the above child agrees to pay DramaZone the non-refundable fee of $_____________________ for _____________sessions. 2. The parent understands that time and date for each of the ___________ sessions has been pre-determined by the Program and provided in advance of the parent and agrees to the dress code provided online. 3. The parent understands and agrees that there is no credit or refund for missed or unused sessions and that all fees paid to the program at the time the registration is confirmed for all classes are non-refundable and non-transferable. 4. The Parent understands and agrees that the Directors/Teachers of the program have the right to terminate the enrollment of any child from the program, at any time if the Director/Teacher, in her sole discretion, determines that the continued attendance of the child in the Program is not in the best interest of the child or the Program, the undersigned acknowledges and agrees that the student?s enrollment may be terminated for a violation of the rules or regulations of the Program, at the Program?s sole discretion, without any refund or cancellation of tuition, which the undersigned nevertheless agrees to pay in accordance with the terms of this contract. 5. The Parent grants the Program and it?s Events permission to include photographs and videos taken during the sessions and events, in which his/her child may appear in all DramaZone materials, literature, informational and /or promotional. 6. In the event that the Parent cannot be reached and a situation arises which the Program Director/ Teacher defines as an emergency, the parent hereby grants permission to the Program Director/Teacher to secure and provide for necessary medical treatment, including hospitalization. 7. The Parent understands that the Program does not have the services of a nurse or other medical personnel on premises to administer medication or provide medical treatment. The undersigned acknowledges and agrees that, to the extent that the student is required to be administered medication during the time that the child is in the program that, non-medical staff would administer such medication. 8. I/we the Parent of the above child understand that part of the experiences that my/our child will be having may be new to my child, and they come with certain risks and uncertainties beyond what my child may be used to dealing with at home or in his/her school environment. I/we realize that no environment is risk-free, and we are prepared to assume on behalf of our child, the risk involved in his/her participation in the DramaZone program. The Parent furthermore releases and holds harmless the Program, its agents and employees from all claims, damages or other liability for injury to the student where such claims, damages, or other liability is not the result of gross negligence by the Program, its agents, or employees. The Parent further agrees and acknowledges that the Program is not responsible for any medical expenses for the child.
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