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Emergency Contact Information

Daliana Dance Waiver and Release of Liability

Assumption of Risk

Participant and Guardian (if Participant is a Minor) agree TO ASSUME AND ACCEPT ALL RISKS arising out of, associated with, or related to Participant’s participation in the Program, transporting to or from the Program, or as a result of any natural disaster, extreme weather condition or event, or any other occurrence during Participant’s participation in the Program, natural or otherwise, even though such risks may have been caused by the negligence of the program. This assumption and acceptance of all risks includes, without limitation, any medical expenses that Participant or Guardian may incur as a result of Participant’s personal injury or illness.

Medical Emergencies

Medical Emergency (Only if under 18)

The undersigned gives permission to Daliana Dance, its owner and operators to seek medical treatment for the participant in the event they are not able to reach a parent, guardian or emergency contact you provide. I hereby declare any physical/mental problems, restrictions, or condition and/or declare the participant to be in good physical and mental health.

Audio/Video/Photo Waiver/Release Form

I hereby grant irreversibly Daliana Dance the right to use and reproduce any and all photographs, video clips, and/or audio clips taken of me or my child in any form whatsoever for use by Daliana Dance in newsletters, brochures, web sites, flyers, and in any other publications produced for the aforesaid school. My child or I can have their picture taken, but at times may not have his/her name printed along with the photo. I waive the right to inspect or approve the finished version(s) of such images including written copy that may be created in connection therewith. Consent is also granted for any use of my (or my child’s) name in any part of those publications listed above. I have read this document and am fully aware of the consent and implications, legal, and otherwise.

Tuition Policy


Tuition and fees are non-refundable and there are no refunds. You may pay in advance for tuition or fees. Tuition is due on the 1st of every month and must be paid to participate in dance class.


Tuition is considered late if received on or after the 6th of the month and a late fee of $25 will be charged to your account.


Tuition will not be prorated due to Late Month Registration, Holidays, Vacations, Absences, Studio Closures and/or Holidays, Vacations, Absences, Studio Closures and/or Illness. *If you choose to withdraw from the studio a 30-day written notice must be received otherwise, you are responsible for said tuition. No refunds.


Returned Check Fee $45

By submitting this form, I agree to pay registration and first month's pricing plan.

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Payment Plan

© 2025 by Dance and Dash a Daliana Dance Company

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