Registration Form

First and Last Name (Self or Parent/Guardian)

Are you a Parent or Guardian signing for a Child?

Yes

Signing on Behalf of (Child's Name)

Phone Number

Address

Date of Birth

Which Class or Event are you signing up for? Required

Adult Class

Kids Class

Perform at Nara Bollywood Dreams Show

Please list any medical conditions we should know:

Liability Waiver

Terms & Release of Liability:

(1) I agree and commit to paying the full fee for the classes chosen. If purchasing a Choreography Program, I agree to pay the fee in full, or divided in 3 equal payments through the Payment Plan. I understand that the Payment Plan is only a financing option for the full program cost, and is not a monthly subscription.

(2) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for participant's death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me and my family including my traveling to and from this class or event, THE FOLLOWING ENTITIES OR PERSONS: Nara Bollywood Dance Academy, Nara Bollywood, Narayani Maharaj-Duncan, Bollywood Dreams Dance Celebration and/or their directors, officers, employees, volunteers, representatives, and agents.

(3) Indemnification, Hold Harmless, and Covenant Not to Sue. On behalf of myself and my family, personal representatives, estate, successors, assigns, heirs, and next of kin, I hereby indemnify, hold harmless, and promise not to sue or otherwise bring a claim against the Released Parties for any loss, liability, expense, or damage arising out of or in any way related to my (or my child’s) participation in or presence at any events, activities, and programs by Nara Bollywood Dance Academy LLC, Narayani Maharaj-Duncan, Bollywood Dreams Dance Celebration (and all activities incidental thereto), whether caused by the negligence of any of the Released Parties or otherwise. I further agree to indemnify the Released Parties from and against any and all third party claims of any kind arising out of or in any way related to my participation in or presence at any events, activities, and programs by Nara Bollywood Dance Academy LLC, Narayani Maharaj-Duncan & Bollywood Dreams Dance Celebration.

Photo & Video Use Release

I Hereby grant and authorize Narayani Maharaj-Duncan, Nara Bollywood Dance Academy or Bollywood Dreams Dance Celebration the right to take, film, edit, alter, copy, distribute, publish, exhibit and make use of any and all pictures and videos taken of me by Narayani Maharaj-Duncan, Nara Bollywood Dance Academy and Bollywood Dreams Dance Celebration to be used in and for promotional materials including but not limited to social media networks, newsletters, flyers, posters, brochures, advertisement, websites, press, tv, letters and any other printed or audio visual and digital communications media without payment or consideration. This authorization extends to all languages, media formats. This authorization shall continue indefinitely unless I otherwise revoke the authorization in writing.

I understand and agree that these materials shall become property of Narayani Maharaj-Duncan, Nara Bollywood Dance Academy and Bollywood Dreams Dance Celebrationand will not be returned.

I hereby to hold harmless, and release Narayani Maharaj-Duncan, Nara Bollywood Dance Academy and Bollywood Dreams Dance Celebration from all liability, petitions and causes of action which I, my heirs, representatives, executors, administrators, or any other persons may make while acting on my behalf or on behalf of my state.

I agree to the terms & conditions of the Liability Waiver.

I accept the terms & conditions listed above.

Your Signature

Thank you for your submission.
Don't forget to purchase your class before attending!