Registration
Registration
Sharifa Asmar and Qarisma Dance Arts
Classes and Events
Please mail with payment to: Sharifa Asmar, C/O 148 Woodfield Dr., Rockingham, NC 28379
Or submit via e-mail:
sharifa@sharifaasmar.com /
phone: 910.461.1265
Class /workshop
Date of workshop/class
Legal Name
Address
Phone and e-mail
Tuition fee No. of classes /dancers
Other
Total enclosed
NO REFUNDS UNLESS CLASS / EVENT IS CANCELLED
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Waiver of liability for participation in events
associated with Sharifa Asmar’s classes/workshops or Qarisma Dance Arts,
regardless of location.
I understand that dance, as with any physical activity, is
learned with some degree of risk. While a safe and quality instruction is
a priority of Sharifa Asmar and Qarisma Dance Arts, injuries can occur.
Sharifa Asmar and Qarisma Dance Arts shall not be held responsible for any
illness or injury that might occur during class, extra-curricular events, or
while on the premises of class locations.
**This about personal responsibility for self and
activities you decide to participate in.
I accept personal responsibility for my participation in
this activity. I will not hold the instructor, or any proprietor of the
building liable for any harm or accidental injury that might occur to me or any
participant or visitor. I also understand that tuition is due at the
beginning of each session by the first class of the session. Dancers with
delinquent accounts will not be admitted to subsequent classes / sessions until
the account is current.
Signature of dancer / *Parent or guardian signature required if
dancer is under 18 yrs.of age.
Date
Signature of dancer / *Parent or guardian signature required if
dancer is under 18 yrs.of age.
Date
“May our dance be a conduit for its healing
energies.”
Carolina Varga Dinicu “Morocco”
2001