Registration Form and Media Waiver

Please mail or deliver deposit of $325 with a printed copy of this registration form to the Summer Intensive Dance Studio. Please print this form out PRIOR to clicking on “Send”.

Final payment is due 3 weeks prior to the first day of the Summer Intensive.

By clicking "I Agree", as parent(s) and / or legal guardian of the child identified above, I hereby release and grant permission to my son / daughter, and or minor for whom I am the parent or legal guardian, the right to participate in any and all activities including but not limited to Summer Intensive classes, rehearsals, auditions, performances, publicity activities, photographic, videotaping (or any other reproduction method known to man now or that may be invented in the future), in connection with ROZ100, INC. d/b/a Moscow Ballet.  . ROZ100, INC. d/b/a Moscow Ballet shall have the right to use any such recordings and photographs as listed above for its own promotional and marketing purposes, INCLUDING ONLINE PROMOTION ON THE NUTCRACKER WEBSITE AND THROUGH SOCIAL NETWORKING WEB SITES (such as Facebook and Twitter, etc.). I hereby further authorize ROZ100, INC. d/b/a Moscow Ballet and those persons designated by ROZ100, INC. d/ b/a Moscow Ballet to supervise said activities and to exercise such judgment and supervision over my child as they deem necessary while he/she is engaged in Summer Intensive classes, auditions, rehearsals, publicity photo(s) and performances. I hereby release and discharge ROZ100, INC. d/b/a Moscow Ballet, their officers, employees, agents and representatives from all claims which the undersigned has, or may have for any injury, loss or damage which my child may sustain by participating in such activities. I understand that a 50% deposit is due upon registration to the host studio for Moscow Ballet’s Summer Intensive and final payment to the host studio is due 3 weeks prior to the first day of the Summer Intensive. I have read and understand the Summer Intensive classes, rehearsal, photos and performance policies of ROZ100, INC. d/b/a Moscow Ballet. I further agree that in all matters requiring parental or guardian consent or permission regarding my child while engaged in said activities, members of the artistic staff of ROZ100, INC. d/b/a Moscow Ballet and their local coordinators shall have authority to represent the undersigned.

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