ADULTS REGISTER ONLINE

Please fill out this registration form. Every student must complete a registration form each session. 

If you choose to pay in person, Cash or checks can be made payable to Moving Arts Exchange and will be accepted in person or mailed to:

325 Stockbridge Rd, Great Barrington MA 01230

Name *
Name
Spring 2018 Passes *
Please select your class pass:
Personal Information
Primary Address *
Primary Address
Phone *
Phone
Date of Birth
Date of Birth
Emergency Contact Name
Emergency Contact Name
Emergency Contact Phone
Emergency Contact Phone
Is there anything that we should know or be aware of?
Consent and Waivers
I grant Moving Arts Exchange unrestricted right to use any photograph/film of me in brochures or other media for promotional purposes.
Release of Liability Agreement *
Release of Liability Agreement
In consideration of being permitted to participate in yoga/dance/meditation, etc. and related activities (the “Program”) conducted by Moving Arts Exchange, Releasor acknowledges and agrees that the risk of injury from activities involved in the Program is significant, including the potential for long-term and permanent injury, and while adherence to particular rules, equipment and personal discipline may reduce this risk, the potential for serious injury does exist, and despite the aforementioned Releasor knowingly and freely assumes the risks, both known and unknown, and further assumes responsibility for his/her own participation in the Program with Lifeworks. Releasor for himself/herself, for his/her spouse, legal representatives, heirs, and assigns, to the greatest extent permitted by Massachusetts law, hereby releases, waives and discharges Moving Arts Exchange, its officers, members, contractors and employees, hereinafter referred to as the “Releasees”, from all liability to the Releasor, his/her spouse, legal representatives, heirs and assigns, for any and all loss or damage, and any claim or damages resulting therefrom, on account of injury to Releasor’s person or property, even injury resulting in death of Releasor, whether caused by the negligence of Releasees or otherwise while the Releasor is participating in the Program. MY SIGNATURE BELOW INDICATES THAT I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A REEASE AND WAIVER OF LIABILITY GOVERNED BY MASSACHUSETTS LAW. I AM 18 YEARS OF AGE OR OLDER, AM LEGALLY COMPETENT TO SIGN THIS AGREEMENT, AND HAVE SIGNED IT OF MY OWN FREE WILL AND ACT. In witness whereof, Releasor has executed this release the day and year first written above.
Complete Registration
Thank you for registering for classes. You will receive an invoice shortly confirming your registration if you have chosen to pay in person. Please contact max@movingartsx.org if you have any questions.