I understand there are certain risks of injury associated with, arising out of and inherent to the activity of dance, and I am willing to assume these risks on behalf of the participant. I understand it is the express intent of Susquehanna Dance Academy to provide for the safety and protection of the students. I also understand that, despite precautions taken by Susquehanna Dance Academy, accidents and injuries may occur.
I hereby certify that I/my child am/is capable of participating in the classes of Susquehanna Dance Academy.
In consideration of my/my child’s participation in the programs of Susquehanna Dance Academy, including, but not limited to, dance classes, shows, performances, and master workshops, I accept all risk to my/my child’s health and or my/my child’s injury or death that may result from such participation and I hereby release Susquehanna Dance Academy LLC, a Pennsylvania limited liability company, its members, officers, employees, instructors, and other representatives from any and all liability to me/my child for any and all claims and causes of action for loss of or damage to my/my child’s property for any and all illness or injury to my/my child’s person, including death, that may result from or occur during my/my child’s participation in classes or to and from classes at Susquehanna Dance Academy, whether caused by negligence of Susquehanna Dance Academy, its members, officers, employees, instructors, representatives, or other third parties. I do hereby release and agree to hold harmless, release and discharge the building owners, Susquehanna Dance Academy staff, assistants, agents, representatives, instructors, directors, and owners, from all liability in the future.
I have carefully read this agreement and understand it to be a release of all claims and causes of action for my/my child’s injury or death or damage to personal property that occurs while participating in classes at Susquehanna Dance Academy. I am 18 years of age or older and authorized to sign as parent/guardian and/or self.