Break Free Hip-Hop School: Houston Registration Form

Registration for Break Free program Summer/Fall of 2026 gives access to up to 2 classes per week - registration is year round and membership (monthly) based

Schedule and Locations (July 2026)
Thursdays at Dance Expressions Studio
6-7pm: Beginners Ages 6+

6-7pm: Boom Baps (Toddlers) Ages 3-5
7-8pm: Intermediate and Champions

Address: 204 W Heritage Dr, Friendswood, TX 77546

Saturdays at Amy Blakes Academy of Dance
3-4pm: Beginners Ages 6+
4-5pm: Boom Baps (Toddlers) Ages 3-5
4-5pm: Intermediate and Champions

Address: 410 E Edgewood Dr, Friendswood, TX 77546

Parent/Guardian First Name *

Parent/Guardian Last Name *

Phone *

Email *

Number of Students *

Student 1 Name *

Student 1 DOB *

Student 2 Name

Student 2 DOB

Student 3 Name

Student 3 DOB

Monthly Tuition: $159/month (1 class per week)
$199/month (2 classes per week)
Registration fee is annual (charged once a year) and per student in the family

Monthly tuition is charged to the card on file (designated below) 3 days after registration form is submitted unless otherwise arranged with a Break Free staff member

Recurring payment date is the same date your first monthly tuition is withdrawn

We do not charge a cancellation fee, we just require a two weeks notice for a hold or suspension before the next invoice date.

Multiple student families - please designate the correct "quantity" below when completing

Tuition Options *

1 Class Per Week: $159/m

2 Classes per Week: $199/m

Monthly Tuition Billing Date (Automatic Payment)

Your recurring tuition payment date will be assigned to the next available billing date following your registration:

1st, 15th, or 25th of each month

For example, if you register on the 16th, your first monthly tuition payment will be processed on the 25th. The 25th will then remain your recurring billing date each month.

By registering myself or my child (“Student”) with Break Free Hip-Hop School / Break Free Worldwide (“Break Free,” “we,” “us,” or “our”), I confirm that I have read, understand, and agree to the following terms.

1. Participation & Assumption of Risk

I understand that hip-hop dance, breaking, movement training, fitness activities, rehearsals, performances, camps, events, and related activities involve inherent risks. These risks may include falls, collisions, strains, sprains, bruises, fractures, illness, property damage, and other injuries that may occur during instruction, practice, travel within the facility, use of equipment, or participation in Break Free activities.

I voluntarily choose for myself or my child to participate and assume all ordinary risks associated with participation.

2. RELEASE OF LIABILITY

I HEREBY RELEASE, WAIVE, DISCHARGE, AND AGREE NOT TO HOLD LIABLE BREAK FREE HIP-HOP SCHOOL, BREAK FREE WORLDWIDE, ITS OWNERS, OFFICERS, EMPLOYEES, CONTRACTORS, INSTRUCTORS, VOLUNTEERS, AFFILIATES, LANDLORDS, AND EVENT PARTNERS FROM ANY CLAIMS, DEMANDS, ACTIONS, DAMAGES, OR LIABILITY ARISING FROM INJURY, ILLNESS, LOSS, OR DAMAGE RELATED TO THE STUDENT’S PARTICIPATION IN BREAK FREE ACTIVITIES, INCLUDING CLAIMS ARISING FROM THE ORDINARY NEGLIGENCE OF THE RELEASED PARTIES.

This release does not apply where prohibited by law, including claims involving gross negligence, recklessness, or intentional misconduct.

3. Medical Authorization

I certify that the Student is physically able to participate in dance and movement-based activities, unless otherwise disclosed in writing to Break Free.

In the event of an emergency, I authorize Break Free staff to seek emergency medical care for the Student when I cannot be reached. I understand that I am responsible for all medical expenses, insurance deductibles, and related costs.

4. Student Conduct & Safety

Students and parents/guardians are expected to treat instructors, staff, fellow students, families, and property with respect. Break Free may remove a Student from class, event, or membership for unsafe behavior, repeated disruption, bullying, harassment, property damage, or failure to follow staff direction.

No refund is guaranteed when removal is due to conduct or safety concerns.

5. Photo, Video & Social Media Release

I grant Break Free permission to photograph, film, record, edit, reproduce, publish, and share the Student’s name, image, likeness, voice, dance performance, and participation in classes, events, rehearsals, camps, competitions, and related activities.

This content may be used for Break Free’s social media, website, advertising, print materials, promotional campaigns, educational content, and other business-related purposes without additional compensation.

I understand that Break Free will make reasonable efforts to represent Students respectfully, but cannot control third-party sharing, reposting, or use of publicly posted content.

6. Text Message Consent

By providing my mobile phone number, I agree to receive text messages from Break Free regarding class updates, schedule changes, registration, billing reminders, events, promotions, and school communications.

Message and data rates may apply. Consent is not required as a condition of purchase. I may opt out of promotional text messages at any time by replying STOP. I understand that opting out may prevent me from receiving important school updates by text.

7. Membership Billing, Cancellation & Pause Policy

Membership tuition is billed according to the billing date selected at registration.

To cancel or pause a membership, written notice must be submitted to Break Free at least two weeks before the next scheduled invoice date. Notices received less than two weeks before the invoice date may not take effect until the following billing cycle.

Memberships remain active, and tuition remains due, until the required notice period has been completed. Failure to attend classes does not automatically cancel or pause membership.

Registration fees, tuition already paid, event fees, camp fees, merchandise, and other completed or reserved services are nonrefundable unless Break Free approves an exception in writing.

8. Changes to Schedule, Instructors, or Programming

Break Free may adjust class schedules, instructors, locations, curriculum, class sizes, or programming when reasonably necessary. We will make reasonable efforts to communicate meaningful changes in advance.

9. Agreement & Electronic Signature

I confirm that I am at least 18 years old and authorized to sign this agreement. If registering a minor, I confirm that I am the parent or legal guardian of the Student.

I understand that checking an acknowledgment box, typing my name, submitting this form, or signing electronically is intended to serve as my legally binding signature.

By signing below, I acknowledge that I have read and voluntarily agree to these Registration Terms, Assumption of Risk, Release, Media Consent, and Membership Policies.

10. Authorization for Card on File Payments

By providing my payment information, I authorize Break Free Hip-Hop School / Break Free Worldwide to securely store my card on file and charge it for agreed-upon registration fees, recurring membership tuition, class packages, camps, events, merchandise, late fees, or other approved services connected to the Student’s account.

I understand that recurring membership charges will be processed on my scheduled invoice date unless I submit a cancellation or pause request at least two weeks before the next invoice date, in accordance with Break Free’s membership policy.

If a payment is declined, returned, disputed, or otherwise unsuccessful, I authorize Break Free to contact me regarding the balance and may reattempt payment using the card on file. I understand that the Student’s participation, enrollment, or access to services may be paused until the account is brought current.

I confirm that I am the authorized cardholder or have authorization to use the payment method provided. I agree to notify Break Free promptly if my billing information changes or if I need to update or remove my card on file.