New Registration

Student Registration Form

Date: 12-Nov-2019

Student Details
Contact Details
Phone / Mobile No(Format: 123-456-7890) ):
Email Id
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Experience
Health & Other Issue
Uniform Measurements Details
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Hobbies
Terms & Conditions
Photo/Video Release

PHOTO/IMAGE RELEASE: I give my consent for images (photographs and/or video) of my dependent to be taken and used to document the activities of NSA. I grant NSA permission to use the image(s) for educational and promotional purposes, to include Facebook, Twitter, Instagram, etc. No names, or personal information, will accompany these images without consent.

Liability Waiver and Acknowledgement of Risk

Natya Shakthi Academy of Arts Liability Waiver and Acknowledgment of Risk: READ AND SIGN BELOW: REGISTRATION IS INCOMPLETE WITHOUT SIGNATURE AND MUST BE COMPLETED BEFORE CLASS: I understand and agree that in participating in any dance class, workshop, rehearsal or performance, there is a possibility of physical injury or death. I voluntarily agree, therefore, to assume all risks and responsibility for any such injury or accident, which might occur to me or my child during any of Natya Shakthi Academy of Arts classes, rehearsals, performances, or activities. I also exempt, release, and indemnify Natya Shakthi Academy of Arts, its owners, agents, volunteers, assistants, employees, guest artists, faculty members, and/or students from any and all liability claims, demands, or causes of action whatsoever from any damage, loss, injury, or death to me, my children, or property which may arise out of or in connection with participation in any classes or activities conducted by Natya Shakthi Academy of Arts. I further hereby voluntarily agree to waive my rights and that of my heirs and assigns to hold Natya Shakthi Academy of Arts, its owners, agents, volunteers, assistants, employees, guest artists, faculty members, and/or students liable for such damage, loss, injury, or death. I understand that I should be aware of my physical limitations and agree not to exceed them. If I am signing this waiver for my children, I certify that I am the parent or legal guardian and have the right to waive these rights. Permission is granted Natya Shakthi Academy of Arts to use photographs and video of students for publicity purposes. I have read, understood and agree to be bound by the above statement (please print your name, sign & date):

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