Student Registration Form
Emergency Phone Number
Parent’s name if a student is a minor
Hold Harmless Agreement
I, the undersigned, agree to hold MODA Fashion Academy or ZoyaModa, LLC harmless for any accident that may occur to myself or my child while attending classes. I understand the sewing instructors will do their best to prevent accidents from happening.
However I, the undersigned participant, for myself and for my heirs, executors, legal representative, successors and assigns, herby waives all claims and/or course of action, including negligence, against MODA Fashion Academy or ZoyaModa, LLC/ Zoya Nudelman for any accident that may occur to myself or to my child while participating in sewing classes and all sewing/craft activities held by MODA Fashion Academy or ZoyaModa, LLC instructors.
I have carefully read this agreement and fully understand its contents. I am aware that this is a waiver, release of liability and assumption of risk agreement between me and MODA Fashion Academy or ZoyaModa, LLC , the Trustees, all offices, directors, employees and agents, arising out of or in any way connected with my participation in the above designated activity.
O I understand and agree to obey all activity rules
O I give MODA Fashion Academy or ZoyaModa, LLC my permission to use my photo on the schools blog, sites, and social media.
O I do not give my permission to MODA Fashion Academy or ZoyaModa, LLC to use my photo on the schools blog, sites, and social media.
(Legal Guardian if under 18years of age)
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