Name *

First Name

Last Name

Date of Birth

MM

DD

YYYY

Phone *

Country

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact *

Who can I contact in case of emergency?

First Name

Last Name

Emergency Contact Phone Number *

Country

(###)

###

####

Rental Waiver *

I have read and agree to the Rental Waiver which is available to me at the link below this form.

Terms & Conditions *

I have read and agree to the following; must check all to continue scheduling process.

I acknowledge the $100 refundable deposit for any damages that occur under our rental period.

I acknowledge that I am responsible for any damages to mirrors, floors, barres, tv, speakers, and property inside Amy Novinski Ballet Class and will forgo my deposit as well as pay for repairs to said items.

I agree to follow the "Renter's Opening and Closing Checklist" provided to me at the time of my rental.

I agree to uphold minimal contact of the mirrors and I will take full financial responsibility for any damages to mirrors during my rental period.

I acknowledge that use of candles, sprays, oils, or lotion is prohibited.

I acknowledge that the use of street shoes or any shoe with the potential to damage the integrity of the floor is prohibited.

I agree to lock both door handle and upper bolt and to return key to locker upon exiting the studio. In addition I acknowledge that failure to do so may result in discontinued use of studio and forfeiture of deposit.

I acknowledge that loss of studio key will result in the financial responsibility of changing the lock on the front door of the studio space and any fees associated with this.

I, and those within my group, agree to follow any and all COVID-19 related protocol set in place by the BOK Building at the time of my rental.

I acknowledge that I am renting within a larger workspace (BOK Building) and will be respectful of noise levels during my rental period.

I have read and agree to all of the above conditions.

I understand that Amy Novinski reserves the right to refuse service to anyone. *

I understand.