Students * Student 1 Info Student Name (1) *
First Last Student Date of Birth (1) *
MM slash DD slash YYYY Student T-Shirt Size (1) * Kids Small Kids Medium Kids Large Student 2 Info Student Name (2)
First Last Student Date of Birth (2)
MM slash DD slash YYYY Student T-Shirt Size (2) * Kids X-Small Kids Small Kids Medium Kids Large Parent/Guardian Information Parent/Guardian Name *
First Last Parent/Guardian Email *
Address * Parent/Guardian Phone * Terms & FAQ Terms of Service Agreement *
I understand I am hiring GroovinKids Dance and Gymnastics to provide instruction to my
child/children. I understand I may make my non-refundable pre-payment via credit card or Venmo (@Katy-Cryns). If a credit card is used, payments will be deducted automatically before the first class.
Legal Waiver *
As a voluntary participant, I recognize and acknowledge that there are certain risks of injury
associated with any form of physical activity, including this activity. I affirm that my child has no
physical, mental, or medical condition that to my knowledge would endanger my child or others if my
child participates. I agree to assume the full risk of injuries, damages, or loss that my child may
sustain as a result of participation. I hereby acknowledge that I understand the risks of participation
and release and discharge GroovinKids and its respective directors, insurers, employees, and
representatives from any claims.
Photo Release * Choose One I agree that my child’s image may be used in GroovinKids marketing materials, including print & internet. I do not agree. Regulations, Covid-19, & Cancellation Policy * GroovinKids Regulations * Clients agree to provide GroovinKids a space in which to work that is free from sharp objects and
obstructions. GroovinKids instructors will provide appropriate mats, props, and music for the session.
* Students are required to wear comfortable clothing that is easy to move and stretch in, with long hair
pulled back in a ponytail or bun.
* In the event of a scrape, bruise, or injury, GroovinKids instructors assess the situation, and
determine and provide the appropriate course of aid. Instructors are trained in CPR/First Aid and are
equipped with basic first aid supplies. Instructors will fill out an Incident Report form that will be
emailed to the parent/guardian following the incident.
* To help stop the spread of COVID-19, instructors will sanitize all mats and equipment prior to
starting the session, wash or sanitize hands, and wear masks at all times. Students are expected to
wash or sanitize their hands before the session. Any child that is ill, feverish, or exhibiting extreme
symptoms associated with COVID-19 will not be allowed to participate in the session. COVID-19 *GroovinKids has put in place preventative measures to reduce the spread of COVID-19; however,
GroovinKids cannot guarantee that you or your child(ren) will not become infected with COVID-19.
Further, attending GroovinKids classes could increase your risk and your child(ren)’s risk of
I understand and assume all risks associated with GroovinKids classes and COVID-19. Cancellation Policy GroovinKids offers exemplary instruction in dance and gymnastics in a mobile capacity, requiring
flexibility on the company’s and clients’ parts alike. By adhering to the cancellation policy below,
GroovinKids’ students can flourish in a consistent environment which is crucial to their success. Cancellations Cancellations must be made 24 hours in advance of the start time for your session. If a cancellation
occurs within the 24-hour period, the client is responsible for 50% of the session fee, barring
extraordinary circumstances to be approved by GroovinKids. No-shows are responsible for 100% of
the session fee. *Same-day illness is included in this policy to protect the income of the instructors. Make-Ups Due to scheduling restrictions, make-up classes are only available when: 1) the cancellation is made
24 hours in advance of the start time for your session, and 2) there is an instructor available at a
different date and time. If these circumstances are not able to be met, a credit may be applied to the
client account for the following month. Late Starts GroovinKids strives to schedule sessions with plenty of time between to account for traffic delays and
emergencies, but due to the mobile nature of the company, situations may arise in which an instructor
is not able to arrive on time for a class. If this occurs, it is our policy to alert the client as soon as possible and make up the missed time at the end of the session. If, for any reason, the session is not able to be extended, the instructor will finish at the scheduled end time and the client will receive either a refund for the remainder or a credit for the following month, based on the client’s preference. For example: if an instructor arrives at a client’s home 15 minutes late, the instructor will complete a 45 minute class and the client will be refunded or credited the financial equivalent to 15 minutes. Payment Payment Preference * Choose One Venmo: @Katy-Cryns Credit Card (Please Call)
Credit Card through Stripe
Your Venmo Name Total
*This is your hourly rate. Your monthly charges are dependent on how many hours of class will take place each month - i.e. if your 1-hour class is on Tuesday, and there are 4 Tuesdays in the month, you will be charged for 4 hours.
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