I, the undersigned, hereby give permission for any and all medical attention to be administered to my child in the event of accident, injury, illness, etc. under the direction of the physician I provided, or by emergency personnel, or any emergency facility, until such time as I may be contacted. I also assume responsibility for payment for any and all such treatment that may be administered.
I, the undersigned, agree to hold harmless: Katie Lombardi (Director), Local Motion Dance Studio, and all persons working with or affiliated with this studio from any and all claims of damage or injury suffered by myself or student(s) in connection with or by the association of Local Motion Dance Studio.
By enrolling my student(s), I certify that he/she is in good physical condition and is able to participate in any and all activities that have been or will be scheduled. I understand and assume all risks associated with dance/tumbling instruction, rehearsal and training at Local Motion Dance Studio or any performances at any location; including but not limited to, risk of bodily injury occurring as a result of executing choreography or tumbling routines, contact with other students, instructors, walls, equipment, floors, supplies or other objects on the premises. I understand that any injuries incurred are the sole responsibility of me, the parent/legal guardian, of my student. I further understand that as I, the responsible party, must carry my own insurance and that dance/acro classes are taken at my own risk and accept this responsibility.
I have read and fully understand the above terms of this waiver and agree to fully abide by its terms.
This release will be valid from day signed through July 31st of the following year.