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Cost:  Classes are $60 for a six-week course if payment is received prior to the class start date.  If you choose not to pre-register and wish to pay on the first day of class, the price is $70 for a six week course.

Unfortunately, this is not a pay per/week program.  You must pay for the entire course in advance or on the first day of class whether you attend every class or not.  However, if after the first class you decide the program is not for you, you can request a partial refund (the amount you paid for the course less $15).

You may join any class up until the second week of the course.  After the second week, you will have to wait until the course starts anew to join.

 

Belly Dance by Samora Class Registration Form
Class Location: Atlanta Fusion Belly Dance
1015 Collier Rd. NW, Suite B
Atlanta, GA 30318

www.atlantafusionbellydance.com

Name:_________________________________________________________

Address:_______________________________________________________

_______________________________________________________________

Phone:________________________________________________________

E-mail:________________________________________________________

Class you are Registering for (Start Date and Time): ______________________________________

Health Conditions or Restrictions:_________________________________________________________________
*Those with medical conditions are advised to get doctor's permission before participating in this, or any other physical activity.

Waiver:  By signing below I agree to participate in classes with Belly Dance by Samora at my own risk.  I acknowledge that there is a risk of injury associated with participating in these belly dance classes, as with any other physical activity.  I hereby waive, release, discharge and covenant not to hold Belly Dance by Samora and any affiliates responsible for any injury that may occur while taking classes or as a result of participating in class.  I also acknowledge that Belly Dance by Samora is not responsible for anything lost, stolen or damaged while I am taking classes at Several Dancer's Core (hereafter "SDC").  Additionally, I hereby agree to indemnify Belly Dance by Samora for any damage that I personally cause to the premises/studio.  I understand that Belly Dance by Samora does not own, operate or manage SDC; but instead leases studio space from SDC as an Independent Contractor. 
I understand that I am signing up for participation in a six week course and not for individual classes.  Therefore, I am responsible for paying the entire amount for the course whether I attend all six classes or not.  I understand that I am entitled to a full refund prior to the start date of the course if I request one in writing from Belly Dance by Samora.  After the first day of class, I understand that I will not receive a refund.  I can, however, request a partial refund after participation on the first day of class (all but $15 of your course fee will be refunded) if I change my mind about taking the class; but I must make a request for the partial refund that day (first day of class).  After the first class, my right to any refund is waived.

I have read and understood this waiver of liability, assumption of risk and indemnity agreement and am signing freely, knowingly and voluntarily.  I further attest that I am at least eighteen (18) years of age.

Sign:___________________________________________   Date:_________________________

Please print and mail completed registration form and payment ($60 if registration received prior to class start date, $70 thereafter) to:

Belly Dance by Samora

1464 Gates Circle SE

Atlanta, GA 30316