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WAIVER AND RELEASE FROM LIABILITY FOR DANCE INSTRUCTION
I, ______________________________________ (PRINT YOUR NAME) have chosen to have my child/or myself ________________________________ (PRINT CHILD’S NAME),or (PRINT YOUR NAME) participate in dance instruction given by Great Commission Studios Corp. (“Great Commission Studios”). I acknowledge that I understand the nature of the activities my child will be participating in and that my child is in the proper physical condition and capable of participating in the related activities, understanding that Great Commission Studios and Reach Art Studio is not in any way responsible for making such a determination.
In consideration of my child’s enrollment in any dance instruction program, I understand and agree on behalf of myself and/or my child, to release, hold harmless, and discharge Great Commission Studios Corp and Reach Studio Arts from all claims, costs, liabilities, expenses or judgments, including attorneys’ fees and court costs for any occurrences in connection with any dance instruction. I assume all risks to my child in connection with any instruction and further release Debbi’s Dance and its owners and employees from liability for any injury sustained by my child while he or she is enrolled in any dance instruction program, including all risks reasonably connected with such activity whether foreseen or unforeseen.
I understand that Great Commission Studio Corp and Reach Arts Studio is not responsible for my child or other children under my supervision who are left unsupervised in the common areas and areas surrounding the dance studio and that Great Commission Studios Corp. will only be supervising my child when he or she is participating in scheduled dance activities, programs or instruction.
I understand that Great Commission Studios Corp. and/or Reach Art Studio is not responsible for personal property that is lost, damaged or stolen while I or my child is at or on Reach Studio Arts’ property.
I acknowledge and agree that it is my responsibility to maintain my own accident and health insurance coverage that provides adequate coverage for myself and my child participating in Great Commission Studios activities and that Great Commission Studios Corp. does not provide accident or health insurance for those participating in its instruction, activities or programs.
I authorize and agree that Great Commission Studios Corp. may take and use photographs, videos or likenesses of myself or my child as needed for its record-keeping, advertising and/or public relations projects and that I have no rights to the same and will not be compensated for the same.
My signature is proof of my intention to execute a complete and unconditional waiver and release of all liability pursuant to the terms herein, and agreement as to all terms and conditions contained above. I am of lawful age and competent to sign this affirmation.
I HAVE FULLY INFORMED MYSELF AS TO THE CONTENTS OF THIS RELEASE AND HAVE READ THE SAME PRIOR TO SIGNING.
Signature of Participant or Participant’s Parent or Guardian Date
Printed Name of Participant or Participants
Parent or Guardian
STUDENT: __________________________ __________________________ ____________________ Last Name First Name Birthdate
ADDRESS: ____________________________________________________________________________ Street City Zip
PARENT/Guardian: ________________________________________ Email: _______________________
PHONE: ________________________ _______________________ ________________________
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