Break Free - Intro Pass Sign Up

For multiple student families, please fill out one form per student

Student First Name *

Student Last Name *

Date of birth *

Parent/Guardian Full Name (if under 18)

Phone *

Email *

Notes - Please share any special notes about your student and/or family

Sell Products *

Intro Pass

This 2 week pass grants full access to Break Free programming for an introductory 2 week period - effective starting on the attendance of your first class.

$59.99

WAIVER OF LIABILITY

I/we realize that participation in Break Free classes and activities could involve some possible personal injury. Despite precautions, accidents and injuries may occur. By signing this release form, I/we (the student and parent/guardian) assume all risks related to the use of any and all spaces used by Break Free. I/we agree to release and hold harmless Break Free including its teachers, staff members, and facilities used by both entities from any cause of action, claims, or demands now and in the future. I understand that Break Free are licensed, accredited and insured organizations. In the event that I/we should observe any unsafe conduct or conditions before, during or after my/our classes, I/we agree to report the unsafe conduct or conditions to any instructor or staff member as soon as possible

MEMBERSHIP TERMS

By enrolling in a membership with Break Free Hip-Hop School, the client agrees to the selected membership timeframe and accepts responsibility for the full payment of membership fees for the entire duration of the agreement. Any cancellation of the membership is subject to Break Free Hip-Hop School's cancellation policy of two weeks noticed before the next invoice date.

SOCIAL MEDIA AND PUBLICATION RELEASE

I hereby grant permission to Break Free to use photographs and/or video of myself and/or my child taken during time at our facilities, recordings in our online classes, or at events related to our business, in publications, news releases, online, and in other communications related to the mission of Break Free.