CURRENT Shumka School Parents: Have your class placement guide sheet available as you will need it to complete your registration. This should have been emailed to you. Contact the Shumka Office (780.455.9559) if you did not receive your class placement guide sheet.

 

NEW Shumka School Parents: Before completing this registration form, please contact June Eeles at the Shumka Office (780.455.9559) for your class placement guide sheet.

 

FAMILY INFORMATION

Last Name*

Mailing Address*

City*

Province*

Postal Code*

Mother's Name*

Father's Name*

Email 1*

Email 2

Cell Number*

Second Phone Number

Emergency Contact Person*

This should be someone other than the parents.
Emergency Contact Number*

How many dancers would you like to enroll using this registration form?*




 

TERMS & CONDITIONS

LIABILITY AND ASSUMPTION OF RISK AGREEMENT

 

In consideration of being allowed to participate in any way in the athletic/sports program, related events, and Shumka School of Dance activities, the undersigned acknowledges, appreciates, and agrees that:

  1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,
  2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
  3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
  4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS, the Ukrainian Shumka Dancers, the Shumka of School of Dance, Shumka Summer Dance Camps, their officers, officials, instructors, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS, AND ACCEPT IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.


DECLARATION OF COMPLIANCE – COVID-19

 

The Ukrainian Shumka Dancers and Shumka School of Dance (hereinafter referred to as “Organization”) require the disclosure of exposure to illness in order to safeguard the health and safety of all participants and limit the further outbreak of COVID-19. This Declaration of Compliance will be kept safe, and personal information will not be disclosed unless as required by law or with your consent.

 

An individual (or the individual’s parent/guardian, if the individual is younger than 18 years old) who is unable to agree to the terms outlined in this document is not permitted to enter the Organization’s facilities or participate in the Organization’s activities, programs, or services.

 

I, the undersigned being the individual named above and the individual’s parent/guardian (if the individual is younger than 18 years old), hereby acknowledge and agree to the terms outlined in this document:

  1. The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization and COVID-19 is contagious. The Organization has put in place preventative measures to reduce the spread of COVID-19 and requires all individuals (or their parent/guardian, when applicable) to adhere to the compliance standards described in this document.
  2. The individual has not been diagnosed with COVID-19, OR if the individual was diagnosed with COVID-19, the individual was cleared as noncontagious by provincial or local public health authorities more than 14 days prior to the date this Declaration of Compliance was signed.
  3. The individual has not been exposed to a person with a confirmed or suspected case of COVID-19, OR If the individual was exposed to a person with a confirmed or suspected case of COVID-19, the date of exposure was more than 14 days prior to the date this Declaration of Compliance was signed.
  4. The individual is attending or participating voluntarily and understands the risks associated with COVID-19. The individual (or the individual’s parent/guardian, on behalf of the individual (when applicable) agrees to assume those risks, including but not limited to exposure and being infected. 
  5. The individual has not, nor has anyone in the individual’s household, experienced any signs or symptoms of COVID-19 in the last 14 days (including fever, new or worsening cough, fatigue, chills and body aches, sore throat, shortness of breath, respiratory illness, vomiting or diarrhea, loss of taste or smell, or difficulty breathing).
  6. If the individual experiences, or if anyone in the individual’s household experiences, any cold or flu- like symptoms after submitting this Declaration of Compliance, the individual will immediately isolate and not attend any of the Organization’s facilities, activities, programs or services until at least 14 days have passed since those symptoms were last experienced.
  7. The individual has not, nor has any member of the individual’s household, travelled to or had a lay- over in any country outside Canada in the past 14 days. If the individual travels, or if anyone in the individual’s household travels outside Canada after submitting this Declaration of Compliance, the individual will not attend any of the Organization’s facilities, activities, programs or services until at least 14 days have passed since the date of return.
  8. The individual is following recommended guidelines, including but not limited to, practicing physical distancing, trying to maintain separation of six feet from others, adhering to recognized hygiene best practices, and otherwise limiting exposure to COVID-19.
  9. The individual will follow the safety, physical distancing and hygiene protocols of the Organization outlined in the “Back to Dance Plan.”
  10. Teachers will take all safety precautions to be able to hand manipulate and correct students as normal.This document will remain in effect until the Organization, per the direction of the provincial government and provincial health officials, determines that the acknowledgements in this Declaration of Compliance are no longer required.
  11. The Organization may remove the individual from the facility or from participation in the activities, programs or services of the Organization at any time and for any reason if the Organization believes, in its sole discretion, that the individual is no longer in compliance with any of the compliance standards described in this document.

MEDIA RELEASE 

 

I acknowledge that certain personal information, including my name or my child’s name and photographic or video image, is collected, from time to time, by Shumka School of Dance, under Ukrainian Shumka Dancers and is required by the Ukrainian Shumka Dancers for its continued and effective operation of Shumka School of Dance, Shumka Summer Dance Camps, and the Shumka Dance Syllabus Academy. The undersigned hereby irrevocably consents to the use of such personal information in connection with its operations and, including but not restricted to, use in connection with any advertisement, marketing product, broadcast, publication, Donor Perfect database software, Shumka website, Shumka App, Facebook page, Twitter page, Instagram page, YouTube page, Dropbox, audio or video recordings, still photographs and artistic renderings without compensation and the undersigned waives the right to inspect or approve any such use in connection therewith.

COSTUME RENTAL CONTRACT  

 

Between:

 

SHUMKA SCHOOL OF DANCE

(hereinafter referred to as “SSD”)

 

And:

 

The undersigned PARENT/GUARDIAN

(hereinafter referred to as “Renter”)

 

Return date of all costumes: May 2022.

 

SSD agrees to rent the dance costume(s) to the Renter in accordance with the Rental Policies contained below.

 

I, the undersigned Renter, agree to rent the costume or costumes, from SSD, for use by the dancer during the regular dance season, returned to the Shumka Dance Centre at the costume drop off date of May 2022 for the rental fee in accordance with the rental policies outlined below. I, the undersigned Renter, have read and agreed to be bound by the rental policies contained in this Costume Rental Contract and acknowledge that these rental policies form a part of this Contract.

 

Costume Rental Policies:

  1. COSTUME RETURN: The Renter agrees to return the costume or costumes, in the same conditions, subject to reasonable wear and tear, to the Shumka Dance Centre at the costume drop off date of May 2022. SSD reserves the right to determine what constitutes wear and tear. Food, beverage, grease, rust, and/or oil stains of any type will not be considered wear and tear.
  2. PURPOSE OF USE: The Renter agrees that the costume or costumes will be used only for the performances and festivals required of the dancer by SSD, unless otherwise agreed upon between SSD and the Renter.
  3. ALTERATIONS: Costumes will be altered to fit the dancer by SSD and must be returned in the same altered condition.
  4. CLEANING: Any cleaning of the costume or costumes, which may be required from time to time, both during and after the Rental Term, will be conducted by, and/or under the supervision of SSD only. If any cleaning is required on an emergency basis, the Renter agrees to use only such cleaning methods or solutions as would be appropriate for the material or fabric requiring the emergency cleaning treatment, and contact Shumka School immediately before doing so.
  5. FEES: Rental fees are determined by the number of costumes being rented. All rentals require a damage deposit of $250.00/family - subject to the costume being returned in the same condition received, subject to reasonable wear and tear as stated above, the damage deposit will be returned in full. No additional damage deposit is needed for costumes rented for Shumka School solos/duets/trios/small groups. The rental fees are as follows:
    1 costume/dancer: $100
    2 costumes/dancer: $150
    3 costumes/dancer: $200
    4 costumes/dancer: $250
    5+ costumes/dancer: $300
    Solos, duets, small groups: $25/costume
  6. RESPONSIBILITY FOR DAMAGES: The Renter is fully responsible for the return of all pieces and for any damages to the costume as determined by SSD in its sole discretion. The Renter agrees that the damage deposit will be utilized by SSD to cover the costs of damages or replacements. SSD is not responsible for accidents or injuries related directly or indirectly to the use of the rented items.

Costume rental fees cover the following:

  1. RENTAL PROCESS (SSD families are not responsible for creating costumes each year).
  2. DEVELOPMENT (new costumes, design work, shipping, English to Ukrainian translation).
  3. CLEANING (handwashing or dry-cleaning, supplies for handwashing, spot treatment).
  4. MATERIALS (hangers, thread, needles, fabric, snaps, buttons, hooks & eyes, Velcro, ribbons, flowers, rickrack, chin straps, bootstraps, safety pins, tape, steamers, etc.).
  5. INVENTORY (duplications of existing costumes based on enrollment).
  6. STORAGE (cost of storing and maintaining more than 700 costumes and hats/headpieces).
  7. COSTUME DISTRIBUTION AND COLLECTION.

PARENT HANDBOOK 

 

The Shumka School of Dance “Parent Handbook,” together with the other materials named in it, contains the information for which dancers and parents are responsible to know. Once the undersigned has agreed to the Terms and Conditions found in this online registration, SSD expects that the undersigned will have complete knowledge of the policies and practices outlined in the Handbook.

 

This includes SSD’s standard policies and procedures in the following areas:

  • Programming
  • Communication
  • Attendance and Punctuality
  • Etiquette
  • Parent View
  • Uniform
  • Costumes
  • Performances
  • Volunteering
  • Fundraising
  • Report Cards
  • Syllabus Examinations
  • Fees

TUITION & FEES 

 

Please contact the General Office for specific class fee information, as SSD does not publicly distribute fee information.

 

Credit, debit, cheque, and e-transfer are the accepted ways to pay. E-transfers can be sent to darka.tarnawsky@shumka.com.

 

Payment Methods:

  1. PAYMENT METHOD A: Monthly payments are based on a full season amount divided into ten equal payments (October 15 Payments 1 and 2, November 1 Payment 3…June 1 Payment 10).
  2. PAYMENT METHOD B: Bi-yearly payments are based on a full season amount divided in half (first half due by October 15, 2021, and the second half due by January 14, 2022).
  3. PAYMENT METHOD C: Lump sum payment due by October 15, 2021.

Refund Policy:

 

Shumka School of Dance refunds after Friday, November 26, 2021, will not be issued. This includes tuition, costume rental fees, festival fees, and syllabus exam fees. Exceptions to this guideline will be made for:

  1. Students with injuries sustained during the calendar season that prevent the student from completing the calendar season. In this case, a doctor’s note is required. All exceptions are determined on a case-by-case basis. Please note that if a cheque is returned NSF, or if a credit card used for monthly/bi-yearly payments is declined, a $25 fee will be levied. In addition, each payment submitted after the relevant deadline is subject to a $25 late fee.
  2. Debilitating/unexpected family emergency that prevents the student from completing the calendar season.

ACKNOWLEDGEMENT

of Parent or Guardian

 
By clicking YES, I, the Parent or Guardian of the Dancer or Dancer's named herein, who is/are in my actual custody, acknowledge that I have read and do understand the Waiver and Consent to which this Acknowledgement is attached. This includes: 

 

  1. LIABILITY AND ASSUMPTION OF RISK AGREEMENT
  2. COVID-19 DECLARATION OF COMPLIANCE
  3. MEDIA RELEASE
  4. COSTUME RENTAL CONTRACT
  5. PARENT HANDBOOK
  6. TUITION & FEES 

I consent and agree to the terms and the binding effect thereof, as they relate to my child or children, and I hereby indemnify SSD from and against claims which may arise.

I give permission for my child or children to participate in the Shumka School of Dance Program.

 

I have read, familiarized myself, and agree with everything in this consent form.

 

After pressing submit, you might need to scroll to the top of the page to view the registration confirmation.

Powered By RackForms