This is a copy of our release
form. We are in the process of
converting it to a pdf which can
be downloaded, but for the time
being, new students / parents  
will need to come to the Dance
Workshop and fill out the
updated form.
2720 Del Rio Place, Davis CA
(530) 756-3949   
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Pamela Trokanski Dance Workshop - Policies and Release Form 2017

1. You must be 18 years, or older, to sign this form.
2. Advance payment is required for all classes.
3. There will be a 10% late fee applied to all outstanding tuition after the first week of each session.
4. We reserve the right to cancel classes.
5. There will be no refunds/credits except for classes that we cancel.
6. Credit due to injury/illness may be granted with a Dr.’s note, beginning from the date we receive
notification.
7. Credit must be used within two years from the day it is granted.
8. Students must sign in at the desk before each class.
9. Students must be on time. Students up to 10 minutes late get one warning. The next time they will not
be permitted into class, and may do a make up for the missed class within the same session. No one
may enter class after 10 minutes past the start of class. Once the warm-up has been missed the risk of
injury increases.
EXCEPTION: Intro to Dance (3+) students may not enter once the class has begun as it is too disruptive.

10. Make-ups must be taken within the same session in which the absence occurred. You must tell the
office staff the date and class that you missed or will miss at the time you take the make-up.
11. Dance cards are non-transferable and non-refundable. They do not expire BUT they are non-
replaceable. Think of them as cash. Once you lose it… it’s gone.
12. Currently enrolled students must register during pre-registration week in order to hold a space for the
next session.
13. Classes may not be disturbed.
14. No cameras / video cameras / cell phone recordings are allowed without the prior consent of the
instructors.
15. Children in the lobby must be supervised. No tapping on the glass is permitted. Children with art
supplies / messy foods must be closely monitored by a supervising adult.
16. Children must be supervised outdoors. Please respect the landscaping. No digging in the courtyard!
17. Dogs must be on leashes.
18. No one is allowed behind the desk except staff.
19. The Dance Workshop is not responsible for personal belongings.
20. Each student / parent is responsible for understanding and adhering to the Dance Workshop dress
code.
21. Please, no dancing/hooping in the lobby. It is distracting to the students and could lead to injury to you
or others.
22. Office staff are responsible for giving information regarding, and enforcing, the policies of the Dance
Workshop. We expect that students and parents comply with office staff requests.
23. From time to time photos and/or video may be taken, for the purpose of creating promotional material
for use at the Dance Workshop and on social media.

□ Check box to opt out of releasing photo/video

Student’s name:
__________________________________________Birthdate_________________


Any medical conditions or allergies?
_________________________________________________________


Parent’s Name (if child enrollment):
_________________________________________________________


Phone - (home):___________________________________ (cel
l):__________________________
Address:
________________________________________________________________________________
Mailing Address (if different than above):
____________________________________________________


Email Address: ___________________________________□ Check box if interested in being on
our email list


In Case of Emergency: (if above contact is unreachable)


Name: _______________________________________________


Phone: ____________________________

In consideration of my participation in the program and intending to be legally bound, I hereby
agree to waive and release any and all rights and claims against the Pamela Trokanski Dance
Workshop and indemnify the same for any liability arising out of or in any way connected with
my or my child’s participation in the program. I also hereby agree that I have read, understand,
and will adhere to, the Dance Workshop Policies.


Signature: ___________________________________________


Date:________________________________________________


FOR OFFICE USE ONLY
Date Received: ________ Initials: _______
Date to MC: __________ Initials: _______
Date to AC: ___________ Initials: _______