CVRC Client

SDP participant

Private/Cash Pay

I certify that I am the parent or legal guardian of the above participant. I hereby consent to the participation in the programs of Limitless Abilities, which includes Limitless Athletics/Sports and Limitless Creative.

I fully acknowledge that sports, classes, performances, etc. may expose participants to certain risks including injury. I acknowledge that participation in these classes are totally voluntary and taken with full knowledge of all the risks involved, even if not mentioned here.

I hereby authorize Limitless Abilities personnel to use their best judgement in contacting and obtaining emergency medical services should it become necessary and agree that they are not responsible for any costs associated with transportation or hospital stay. I also authorize that Limitless Abilities personnel/staff render emergency treatment that he/she deems necessary. *

I agree that I must remain present and on campus during classes available to support my child as needed unless other arrangements are made with the teachers. You're welcome to wait in the lobby or in the classroom, whichever is best for your student.*

I will refrain from being on my phone while my student is in class. If I need to make a call, I will step out into the lobby to do so to keep the distractions to a minimum.*

ABA and other therapists are always welcome to attend class with participants. I will let Limitless Abilities know ahead of time if this will be happening.*

I understand that though these classes are open to anyone of any ability, Limitless Abilities cannot guarantee typical peers will sign up and join us for class. We strive for inclusive classes but this is not always possible.*

I understand that if a class has less than three participants we may need to move your participant to another day/time or cancel his/her class alltogether. *

I understand that no refunds or credits will be given after fees are paid and Limitless Abililities is unable to provide make up classes at this time.*

I understand that invoices are due by the 5th of each month or they will incur a $25 late fee. I also understand that after two months of no payment, my student will be dropped from class unless other arrangements are made.*

For CVRC/SDP participants: I agree that it is ultimately my responsibility to contact your Service Coordinator for a referral to Limitless Abilities, make sure they are offically in our budget (SDP), and that they are processing payment to Limitless Abilities. Without a referral from our worker, my student cannot be registered fully and may lose their spot in class if it becomes full.*

If I have a concern or complaint, I will discuss it with the teacher privately before taking other measures.*