Acknowledgment of Risk and Waiver of Liability Agreement
DISCLAIMER: MAD HOUSE DANCE COMPANY (INCLUDING ITS OWNERS, OFFICERS, DIRECTORS, INSTRUCTORS, VOLUNTEERS, PARTICIPANTS, AGENTS, AND/OR EMPLOYEES) IS NOT RESPONSIBLE FOR ANY INJURY TO ANY PERSON OR LOSS/DAMAGE TO ANY PROPERTY WHILE PARTICIPANT IS OBSERVING, PRACTICING, TAKING CLASS, COMPETING, AND/OR PARTICIPATING IN ANY MAD HOUSE DANCE COMPANY EVENT(S), AND WHILE PARTICIPANT IS OBSERVING, PRACTICING, COMPETING, AND/OR PARTICIPATING IN ANY OUTSIDE EVENT IN CONJUNCTION WITH MAD HOUSE DANCE COMPANY, FOR ANY REASON WHATSOEVER.
In consideration of my participation and the services offered by Mad House Dance Company, its owners, officers, directors, instructors, volunteers, participants, agents, employees, and all other persons or entities acting in any capacity on its behalf (hereinafter collectively referred to as “MHDC”), I hereby agree to acknowledge and release, indemnify, hold harmless and discharge MHDC, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows:
I acknowledge that my participation in aerial arts, and aerial activities, entails known as well as unanticipated risks that could result in physical or emotional injury, paralysis, death or damage to myself, to property, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. The risks include, but are not limited to: slips and falls, falling from equipment, fabric burns, pinches, scrapes, twists and jolts that could result in scratches, bruises, sprains, lacerations, fractures, concussions, or even more severe life-threatening hazards; strains, cuts, bruises, muscle soreness, tears, and fractures; musculoskeletal injuries including head, neck, and back; injuries to internal organs; the negligence of other participants or other persons with this activity. In any event, where I am injured and require medical assistance, I acknowledge said assistance is done at my own expense. Furthermore, I acknowledge that MHDC, instructors and employees have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant’s fitness or abilities. They might misjudge environmental conditions. They may give incomplete instructions or warnings, and the equipment being used might malfunction.
I hereby voluntarily release, forever discharge and agree to indemnify and hold harmless MHDC from any and all claims, demands, or causes of action, which are in any way connected to my participation in this activity or my use of MHDC equipment or facilities, including such claims which alleged negligent acts or omissions of MHDC.
I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating in this activity, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have.
By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against MHDC on the basis of any claim from which I have released MHDC herein.
I acknowledge that I have had sufficient opportunity to read this entire document. I have read and understood it in its entirety and I agree to be bound by its terms and conditions. I expressly agree and promise to accept and assume all of the risks existing in this activity. I acknowledge that my participation in this activity is purely voluntary and I elect to participate in the activity in spite of the risks.

Medical Release Agreement
In the case of a medical emergency, the Mad House Dance Company will make every effort to contact you as soon as possible. In case we cannot, we need your consent, which will allow the staff to secure the necessary emergency care.

By providing your signature below, the student named on this form (and parent(s) or guardians also signing below if the student is under 18 years of age) represent to the Mad House Dance Company that each of the signing below understands the risks of injury that are described below and agrees that the named student assumes all risks associated with participation in activities offered by the Mad House Dance Company, including without limitation, dance classes, Pilates or weight training, rehearsals, workshops or other activities. By signing below, the named student (and parent(s) or guardians also signing below if the student is under 18 years of age) further agree to hold the Mad House Dance Company harmless, its agents, Trustees, officers and employees all as set forth below. For the purpose of this Agreement, “I” shall refer to the student and, where appropriate, the parent(s) or legal guardians of the student named in this form who have signed below.

I am aware that participation in the Classes can be a dangerous activity involving MANY RISKS OF INJURY. I hereby voluntarily assume all risks associated with participation and agree to hold harmless the School, its trustees, officers, employees, and agents from and all liability, claims, causes of action or demands of any kind and nature whatsoever which may arise by or in conjunction with my participation in any activities related to the Classes, including, but not limited to, any medical care given to me and the transportation connected therewith, except for gross negligence. The terms of this agreement shall serve as a release and assumption of risk for me, my parent(s) or legal guardian who has signed below, heirs, estate, executor, administrators, assignees and all members of my family.

To the best of the knowledge of each person signing below, the student named in this form is in good health and suffers no disability or condition which renders his or her participation in the Classes or other athletic activity inadvisable, or otherwise limits his or her ability to participate in such dance activity without restriction. I hereby authorize all representatives of the Mad House Dance Company to obtain in my behalf first aid, medical care, or if necessary, admission to an appropriate health care facility, including, but not limited to, anesthesia and surgery, should such care become necessary for the treatment of any injuries I may sustain while attending the Mad House Dance Company. I also hereby consent to the administration of emergency medical treatment in the event I am unable subsequent to such injury to give consent as otherwise would be necessary. Any qualified medical personnel are hereby notified that this authorization is currently in effect as such personnel are directed to act upon such authorization without delay. I understand that reasonable efforts will be made to contact parents, the student’s physician and/or the emergency numbers given by me on this form.

Registration Fee
A non-refundable fee of $15 per child or $20 family is required annually at the time of registration, whether enrolling for dance or acrobatics/gymnastics.

Payment of Fees
The first payment AND registration fee are due when you enroll. The remaining payments are due the 1st of each month beginning July 1. Payments are always due in advance of service. All payments must be received by the 15th of each month or a late fee of $15.00 is automatically added to your account. If a payment is 30 days late, the student will not be allowed to take class until the account is current. August or 1st month’s tuition is non-refundable. We do not issue REFUNDS or prorate fees.

Payment Forms
Payments are accepted in the form of check, Venmo, Visa, or MasterCard credit/debit cards and Autopay at our website! No additional fees are charged for debit/credit use.

Tuition for Summer 2025 Dance, Acrobatics/Gymnastics/Cheer Classes:
1 hour per week = 4 hours per month $32 per month
2 hours per week = 8 hours per month $64 per month
3 hours per week = 12 hours per month $96 per month
4 hours per week = 16 hours per month $128 per month
5 hours per week = 20 hours per month $160 per month
6 hours per week = 24 hours per month $192 per month
7 hours per week = 28 hours per month $224 per month
8 hours per week = 32 hours per month $256 per month
Nitro Company Summer Requirements(June 16 - August 16) = 150 hours $150 per month
Inferno Company Summer Requirements(June 16 - August 16) = 60 hours $125 per month
Ignite Company Summer Requirements(June 16 - August 16) = 20 hours $105 per month

PHOTO RELEASE FORM
Students of Mad House Dance Company may have the opportunity to be photographed or videotaped at various dance events, including class. With permission from parents these photos or videos may be included for Mad House Dance Company publications or advertisements, including on our website and various social media sites.
To ensure privacy, specific names of children will not be included. No financial compensation shall be given for use of any photographs or video.
I acknowledge that Mad House Dance Company may choose not to use my photo or video at this time, but may do so at its own discretion at a later date. Mad House Dance Company reserves the right to discontinue use of photos or video without notice. I have read this release and I understand its contents. I consent to and authorize the use by Mad House Dance Company, or anyone authorized by Mad House Dance Company, of any and all photographs or videos which have been taken of my child/children.