NEW ADULT CLASSES! FALL SEMESTER

Media Recording/Usage Release

I hereby give my consent for the image and likeness of

___________________________________

to be videotaped, audiotaped, or photographed for the following uses:

• Educational/Instructional media

• Recruitment/Outreach media

• Development media

• Newsworthy media documentation

I further authorize MOGA CONSERVATORY OF DANCE to use this electronic media and/or

photographs in any manner-whole, or in part.

This waiver includes usage of this media in any way deemed appropriate, which may include electronic

and photographical reproductions thereof for the production of educational, instructional, promotional,

or institutional advancement materials which support the educational and outreach activities of MOGA

CONSERVATORY OF DANCE.

I hereby waive any right I may have to inspect or approve any use of this electronic media and/or

photographs and I release MOGA CONSERVATORY OF DANCE and its component parts from all

liability which could result from its use.

Tuition Policy

(1)1st payments can be made in cash, check, or through the online portal. (Please make check to “MOGA”).

Subsequent monthly payments must be made through the online parent portal on Dance Studio Pro with

an account on file.

(2) There will be a $30 fee for returned checks.

(3) If a payment is not made on the student’s first class after the due date, a $25 late fee will be charged,

and participation of the student will be discontinued until the payment is received.

(4) All tuition is non-refundable, non-transferable, and cannot be prorated. No exceptions allowed.

1 Class One-time Payment

October 21st-

December 9th

(8 classes)

$80

THREE

PAYMENTS

1st Payment Due on the day of 

registration ($30)

Due on November 1st ($50)

Due on December 1st ($50)

Drop in Rate: $25

I, _______________________, desire to attend classes at MOGA CONSERVATORY OF DANCE. The Conservatory program includes dance training and educational activities. I understand that there is some risk of injury inherent in the dance training, educational and recreational activities included in the dance classes and that MOGA CONSERVATORY OF DANCE shall not be responsible for any injuries or damages

suffered during my participation in the Conservatory’s program. I, therefore, consent to my participation at MOGA CONSERVATORY OF DANCE.

INDEMNIFICATION: Furthermore, I hereby agree to indemnify and hold harmless MOGA

CONSERVATORY OF DANCE and/or the agents, employees independent contractors, representatives and directors of this institution (collectively, the "Indemnified Parties") for any loss, claim, damage, suit, costs or expenses, including attorneys' fees and court costs, resulting from or arising out of any injury to any

person or damage to property, caused by or incurred by myself, incurred as a result of or during the conservatory’s program or any activities in connection with the MOGA CONSERVATORY OF DANCE program.

RELEASE: In consideration of MOGA CONSERVATORY OF DANCE, I do hereby voluntarily waive and release any and all actions, claims and demands for any damage, injury or loss to person or property which

may be sustained by myself directly or indirectly whether caused by negligence or otherwise during the course of or as a result of participating in the program. I FURTHER UNDERSTAND THAT THIS RELEASE AND INDEMNIFICATION SHALL BE BINDING ON

MYSELF, MY PERSONAL REPRESENTATIVES AND HEIRS.