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MAIN DIVISION
WAIVER, RELEASE and
REGISTRATION AGREEMENT

2019-2020

ACADEMY WAIVER & RELEASE AGREEMENT

CONSENT AND WAIVER OF LIABILITY

I permit my student to attend and participate in all classes, activities and events at the Otto M. Budig Academy of Cincinnati Ballet (the "Academy"). I understand ballet training at the Academy requires sustained, repetitive, vigorous physical activity, usually performed on a wood floor or lightly padded surface without protective footwear (i.e. athletic shoes). I also understand dance instruction involves kinetic corrections which may include physically touching as part of regular class work and rehearsals. I also realize there are inherent risks of serious injury in all the above activities as well as in the general participation of Academy activities and events.ation of Cincinnati Ballet Academy activities and events.

I shall indemnify, hold harmless and defend Cincinnati Ballet, including its employees, agents and trustees (the "Cincinnati Ballet") against any and all claims, actions or suits brought for damages or alleged damages, and from all liability, loss and expense, including reasonable legal expenses, resulting from any injury to person or property or from loss of life sustained by my student while my student participates in classes, rehearsals, performances and activities on the premises of Cincinnati Ballet’s Otto M. Budig Academy, Music Hall, The Aronoff Center for the Arts and other venues where these activities may take place.ems.

I understand my student is responsible for maintaining control over all personal items and agree that I shall not hold Cincinnati Ballet liable for the loss or theft of my student’s personal items.

By signing below, I indicate I have read, understand, and agree to the terms of the consent & waiver of liability above in its entirety.

Parent/Guardian Signature:


Date: February 22, 2020 

MEDICAL RELEASE

I declare I have either consulted a physician or voluntarily chosen not to consult a physician regarding my student’s health before the course of classes and activities at the Otto M. Budig Academy. I have been warned my student must be in good health to participate in the program and I now declare that my student is in good health.

I understand that as a parent or guardian, I will be contacted if non-emergency medical attention is required for my student while attending classes or activities at Cincinnati Ballet’s Otto M. Budig Academy. If I cannot be reached, I authorize the staff of Cincinnati Ballet to arrange for treatment as necessary, at my expense.

Furthermore, if emergency/urgent care is deemed necessary, I hereby authorize Cincinnati Ballet and its employees and representatives as the agent for the undersigned to consent to emergency medical or dental care for my student, including x-ray, MRI, and other diagnostic imaging examination, anesthetic, dental, medical, or surgical diagnosis or treatment, or hospital care under the supervision and upon the advice of a licensed physician or dentist. In such event, Cincinnati Ballet is authorized to submit to the treating facility the medical information set forth on my student’s registration form. I understand that I am solely responsible for any medical, health or personal injury costs resulting from my student’s participation in Cincinnati Ballet and Academy activities.

By signing below, I indicate I have read, understand, and agree to the terms of the medical release above in its entirety.

Parent/Guardian Signature:


Date: February 22, 2020 

NON-DISCRIMINATION & NON-HARASSMENT POLICY AND AGREEMENT

Please read and discuss the policy below with your student and indicate your agreement with and adherence to this policy by signing below.

Cincinnati Ballet believes in the power of dance to connect all people and as such is dedicated to the equitable, dignified and respectful treatment of all people in an environment free from harassment or discrimination. The Otto M. Budig Academy prohibits harassment of any kind to or by any persons including but not exclusive to teachers, staff, students, parents and persons doing business with the Academy. This prohibition includes harassment for any unlawful or discriminatory reason such as race, gender, national origin, disability, age or religion. This policy also prohibits actions which, while they may not be serious enough to constitute harassment in a legal sense, are nevertheless commonly understood to be abusive and disrespectful to others. Slurs, jokes, gestures, comments or rumors which are derogatory of a person’s race, ethnic background, religion, gender, disability, sexual orientation, economic status or age are inappropriate for any Academy related event or activity. This policy extends beyond verbal and physical harassment to include any form of online or digital harassment or bullying. Bullying also includes but is not limited to acts of intimidation or threatening behavior. The subject of bullying need not be aware of commentary, threats or intimidation for such actions to be construed as bullying. Each person is responsible for exercising his or her own good judgment to avoid engaging in conduct which may be in violation of this policy. A person who believes himself or herself to be the victim of discrimination or harassment or a person aware of discrimination or harassment of another person has an obligation to report the incident to an Academy Director or Principal. If a student only feels safe informing a parent, the parent should notify an Academy Director or Principal immediately so they have opportunity to address the situation and prevent further incident to the best of their ability. The matter will be dealt with confidentially with disclosure only to the extent necessary for fair resolution of the matter and only to those requiring immediate knowledge. Failure to comply with this policy will result in disciplinary action which may include removal from the program.

I have read the Academy’s Non-Discrimination & Non-Harassment Policy and have reviewed this policy with my student. By signing below, both I and my student acknowledge reading this policy and agree to adhere to the guidelines set within. 

Parent/Guardian Signature:


Date: February 22, 2020

 

MEDIA RELEASE

I hereby give to Cincinnati Ballet, its legal representatives and assigns, those for whom Cincinnati Ballet is acting, their media and partner organizations, and those acting with their authority: the permission to record and use in any medium my student’s image and/or sound and give all rights to the sound, still, or moving images to Cincinnati Ballet. I further give the unrestricted right and permission to copyright, use, and publish my student’s image and/or sound in which my student may be included intact or in part in conjunction with my student’s own or a fictitious name for promotion, advertising, or any other purpose whatsoever. I also permit the use of any printed material in connection therewith. I hereby relinquish any right I may have to examine or approve the completed product or products or the advertising copy or printed matter that may be used in conjunction therewith or the use to which it may be applied. I hereby release, discharge and agree to hold harmless Cincinnati Ballet, its legal representatives or assigns, and all persons functioning under their permission or authority, or those for whom they are functioning, from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use, that may occur or be produced in the taking of said picture or in any subsequent processing or publication thereof, including without limitation any claims for libel or invasion of privacy. I consent to the use of my student’s sound, still or moving images in all other purposes not explicitly mentioned herewith.this consent.

By signing below, I indicate I have read, understand, and agree to the terms of the media release above in its entirety.

Parent/Guardian Signature:


Date: February 22, 2020

 

ACADEMY REGISTRATION AGREEMENT

REGISTRATION & ENROLLMENT

I understand I am registering for classes through the end of the 2019-2020 Academy year.

I understand by submitting registration, I’m securing a place in class for my student and am financially responsible for that place regardless of my student’s attendance in class. I further understand I have several withdrawal and refund options available to me which are outlined below in further detail.

I understand the value the Academy places on performance as an essential element of my student’s education and that the opportunity to perform in Spring Production is meant to affirm their technical and artistic development. I understand this requires regular class attendance. Note: this does not apply to students enrolled in Petite Pas de Deux, who do not perform in Spring Production.

I understand the Academy staff will make their best effort to enroll my student in their preferred class selection(s) but that registration is processed on a first-come, first-served basis, and there are size limits to each class. While returning students are given priority registration through June 9, the Academy is not able to guarantee or reserve space in any given class.

I understand classes not reaching the minimum enrollment requirement of 6-8 students may be canceled, and in the event of class cancelation, a member of the Academy staff will contact me and make their best effort to find another class suitable to my student’s needs. If a comparable class is not found, I will be reimbursed the cost of paid tuition, less the weeks of classes provided.

WITHDRAWAL POLICY

I understand the Academy wants my student to have a positive and rewarding experience and they have the option to withdraw from classes should it not be the appropriate fit for them at the time. Should I choose to withdraw my student, I understand I remain responsible for the full price of tuition unless any one of the following circumstances apply:

  1. My student’s preferences change and I submit a Withdrawal Form to the Academy Office within one of the following Early Withdrawal Periods:
    • Fall Early Withdrawal Period: The first 2 weeks of the Academy year (August 19-September 1, 2019, for Main Division students and September 9-22, 2019, for Children’s Division students);
    • Winter Early Withdrawal Period: The first 2 weeks of 2020 (January 1-14);or
    • Seven days after my student’s first class (if I register between the Fall and Winter Early Withdrawal Periods).
       
  2. My student becomes seriously ill or injured and I submit a Withdrawal Form with a signed physician’s notice indicating my student cannot continue ballet instruction due to a medical condition within four weeks of the onset of the condition, or
     
  3. Our family relocates and I submit a Withdrawal Form with documentation of family relocation within four weeks of relocation. 

I understand I am financially responsible for the full price of tuition unless the above circumstances apply and I officially withdraw my student via the Early Withdrawal Form available with the Academy handbook and on the Academy’s website. While the Academy appreciates verbally notifying a member of the Academy faculty or staff of intent to withdrawal, written documentation is required. Failure to attend or return to class does not constitute notification of withdrawal.

PAYMENT POLICY

I understand I will be charged a $30 fee for all payments received more than 10 days past the payment due date, a $30 fee on all declined credit card transactions and a $30 fee on all returned checks.

I understand should my payment be more than 30 days past due, my student will be not be able to participate in class until payment is made. I further understand tuition balances not paid in full by May 1, 2020 may result in my student’s inability to perform in Spring Production.

I have read and understand the policies stated above and indicate my agreement by initialing each item and signing below. I understand my registration will not be processed without this signed agreement.

First Student's Name

First Name*

Last Name*
First Student's Date of Birth*
I certify that I am 18 years of age or older
First Student's Information

Student Level: *
First Student's Signature*
Second Student's Name

First Name*

Last Name*
Second Student's Date of Birth*
Second Student's Information

Student Level: *
Third Student's Name

First Name*

Last Name*
Third Student's Date of Birth*
Third Student's Information

Student Level: *
Fourth Student's Name

First Name*

Last Name*
Fourth Student's Date of Birth*
Fourth Student's Information

Student Level: *
Fifth Student's Name

First Name*

Last Name*
Fifth Student's Date of Birth*
Fifth Student's Information

Student Level: *
Sixth Student's Name

First Name*

Last Name*
Sixth Student's Date of Birth*
Sixth Student's Information

Student Level: *
Seventh Student's Name

First Name*

Last Name*
Seventh Student's Date of Birth*
Seventh Student's Information

Student Level: *
Eighth Student's Name

First Name*

Last Name*
Eighth Student's Date of Birth*
Eighth Student's Information

Student Level: *
Ninth Student's Name

First Name*

Last Name*
Ninth Student's Date of Birth*
Ninth Student's Information

Student Level: *
Tenth Student's Name

First Name*

Last Name*
Tenth Student's Date of Birth*
Tenth Student's Information

Student Level: *
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

Student Level: *
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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