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I grant permission to Cultivate Dance Company, to use my image (photographs and/or video) for use in Media publications including: Videos - Email Blasts - Recruiting Brochures - Newsletters - Magazines - General Publications - Website and/or Affiliates - Other

I hereby waive any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the image.

I am at least 18 years of age and/or the parent or legal guardian of a registered dancer and I have read this release before agreeing. I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.

IN CONSIDERATION OF the risk of injury that exists while participating in DANCE (hereinafter referred to as the "ACTIVITY"), and

IN CONSIDERATION OF my desire to participate in said ACTIVITY and being given the right to participate in the same;

I HEREBY, for myself, my heirs, my executors, administrators, assigns, or personal representatives (hereinafter collectively, "RELEASOR", "I" or "ME", which terms shall also include RELEASOR'S parents, or guardian if RELEASOR is under 18 years of age), knowingly and voluntarily enter into this WAIVER & RELEASE OF LIABILITY and hereby waive any and all rights, claims or causes of action of any kind arising out of my participation in the ACTIVITY; and

I HEREBY release and forever discharge CULTIVATE DANCE COMPANY, LLC located at 123 Poplar Pointe Drive (Unit B), Mooresville, NC 28817, their affiliates, managers, members, agents, attorneys, staff, volunteers, heir, representatives, predecessors, successors, and assigns (hereinafter collectively, "RELEASEES") from any physical or psychological injury that I may suffer as a direct result of my participation in the aforementioned ACTIVITY.

I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I am aware of the risks associated with participating in this ACTIVITY, which may include but are not limited to: physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and death. I understand that these injuries or outcomes may arise from my own or others' negligence, conditions related to travel to and from the ACTIVITY, or from conditions at the ACTIVITY location(s). Nonetheless, I assume all related risks, both known and unknown to me, of my participating in this ACTIVITY.

I FURTHER ACKNOWLEDGE that this ACTIVITY may involve a test of a person's physical and mental limits and may carry with it the potential for serious injury, property damage, or even death. I agree to not participate in the ACTIVITY unless I am medically able, and I agree to abide by the decision of the CULTIVATE DANCE COMPANY, LLC official or agent, regarding my approval to participate in the ACTIVITY.

I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS "WAIVER & RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I expressly agree to release and discharge CULTIVATE DANCE COMPANY, LLC and all of its RELEASEES from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I otherwise have to bring a legal action against CULTIVATE DANCE COMPANY, LLC for personal injury or property damage.

I agree that this RELEASE shall be governed for all purposes by North Carolina law, without regard to any conflict of law principles. This RELEASE supersedes any and all previous oral or written promises or other agreements.

This WAIVER and RELEASE OF LIABILITY shall remain in effect for the duration of my participation in the ACTIVITY during the time frame of AUGUST 19, 2024 through JUNE 15, 2025.

I HERBY CERTIFY that I am the parent or guardian and do hereby give my consent without reservation to the foregoing on behalf of this individual. I affirm that I am of the age of 18 years or older, and that I am freely signing this agreement. I certify that I have read this agreement, that I fully understand its content and that this release cannot be modified orally. I am aware that this is a RELEASE OF LIABILITY and that I agree to it at my own free will.