I authorize MUMBAI MADNESS to automatically bill the card listed or initiate electronic debit (e-check/ACH) against the bank account listed as specified. I understand that this authorization will remain in effect until I cancel it in writing to Dance@MumbaiMadness.com, and I agree to notify MUMBAI MADNESS in writing to Dance@MumbaiMadness.com of any changes in my account information or termination of this authorization at least 1 month prior (30 days) to the next billing date. In the case of an ACH Transaction being rejected for Non Sufficient Funds (NSF) I understand that MUMBAI MADNESS may at its discretion attempt to process the charge again within 30 days, and agree to an additional $25 charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this credit card/bank account and will not dispute these scheduled transactions with my bank or my credit card company so long as the transactions correspond to the terms indicated in this authorization form. I understand that there is a minimum of 3 months commitment for classes. I authorize Mumbai Madness to apply my deposit or charge my card or initiate electronic debit against my bank account for the applicable commitment period if I discontinue classes prior to the completion of the commitment period.
WAIVER OF LIABILITY
This agreement is by and between Lavina Punjabi, DBA Mumbai Madness, DBA ZumBolly, Lavina Punjabi’s Associates, Instructors authorized by Lavina Punjabi, Ektaa Center facility and its owners, any other location where Lavina Punjabi conducts classes (referred to as “Mumbai Madness” hereafter) and the individual whose name is printed and signed below:
I, hereby agree to the following:
I am participating in dance and/or fitness and/or other classes (referred to as “classes” hereafter) that are offered by Mumbai Madness and during which I will receive information and instruction about these classes. I understand and acknowledge that all classes require physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
My child is participating in classes that are offered by Mumbai Madness and during which my child will receive information and instruction about classes. I understand and acknowledge that all classes require physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
I understand that it is my responsibility to consult with a physician prior to and regarding my participation or my child’s participation in any or all of the classes. I represent and warrant that I am or my child is physically fit, and I or my child has no medical condition that would prevent full participation in any or all of the classes.
In consideration of being permitted to participate in any or all of the classes, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I or my child may incur as a result of participating in any program or being on the premises.
In further consideration of being permitted to participate in any or all of the classes, I knowingly, voluntarily and expressly waive any claim I or my child may have against Mumbai Madness for damages, and injury, including death, that I or my child may sustain as a result of participating in any class or being on the premises.
I, my heirs or legal representatives forever release, waive discharge and covenant not to sue Mumbai Madness for any injury or death caused by my or my child’s voluntary participation in any class or being on the premises.
I understand that photos or videos that may be taken of class participants or other activities involved with Mumbai Madness, and its programs / classes and give permission that any in which I or my child may appear may be published in local publications, web media, and/or videos.
I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above. This agreement remains in effect for as long as I and/or my child participate in any class.
There are no makeup classes, refunds, or adjustments.
No class around federal holidays.
Performance counts as a class.
Performance fee applies where required and must be paid in advance to be allowed to participate in the performance.
Video recording is not permitted in class.
No toys are allowed during class. No pets are allowed.
We do not provide childcare for non-students. Non student children must be supervised by parent or guardian at all times.
COSTUME REQUIREMENT (Does not apply to Fitness)
We do our very best to get the best prices for costumes. Other schools charge $120 - $150 for costumes. Our costumes range from $60 - $120. Costume fees must be paid by the due date set to participate in the performance.
There are no refunds or exchanges for costumes.
Alteration and/or modification cost of costume is student’s responsibility and not of MUMBAI MADNESS or its vendors.
I understand that terms of service may be changed or updated and agree to the most recently updated terms of service.