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In signing this Release, I acknowledge and represent that I have fully informed
myself of the content of the waiver and hold harmless agreement by reading it before I sign it, and I understand
that I sign this document as my own free act and deed; no oral representations, statements, or inducements,
apart from the written statement, have been made. I further state that I am at least eighteen (18) years of age
and am fully competent to sign this agreement; and that I execute this release for full, adequate, and complete
consideration fully intending to be bound by the same. I further state that there are no health-related reasons or
problems which preclude or restrict my or my child's participation in this activity, and that I will pay any
medical costs that may be attendant as a result of injury to me or my child.

In case of physical injury or medical emergency, I hereby authorize Maddox Dance
Company to make necessary arrangements to transport myself or my child to a medical treatment facility as
necessary. All such transportation and medical treatment will be at my sole cost and expense. In extreme
emergency, or if my child is under 18 years of age, I understand that Maddox Dance Company will attempt to
notify the person(s) I have named below as my emergency contact(s) of my condition and how to reach me.

Maddox Dance Company reserves the right to use photographs and videos taken during
classes, workshops, performances, or other affiliated events for the purposes of instruction, advertising and
promoting Maddox Dance Company and its programs. Students, or parents of students who are minors, who do
not wish to comply with this policy must notify Maddox Dance Company prior to participation in class.

I understand and agree that it is my sole responsibility to safeguard my personal
property while attending or participating in any classes, rehearsals, workshops, or performances. I hereby
release Maddox Dance Company, its affiliate dance studios, event sponsors, employees and dance teachers from
all liability for loss or damage to my personal property while attending or participating in classes, rehearsals,
workshops, or performances. I also agree to abide by any rules, regulations and policies set forth by Maddox Dance
Company.

All participants and students must complete this form before participating in any classes at Maddox Dance
Company. If participant is under age 18, a parent or guardian must also sign this form.
Admission to class and/or rehearsal will not be granted if this form is not received prior to class and is not
properly signed.

Waiver of Liability: I, ___________________________ , recognize and understand the risks of physical injury
inherent to dance and dance training and I fully assume those risks. I hereby release Maddox Dance Company,
event sponsors, employees and dance teachers from all liability for injuries sustained or illnesses contracted
while attending or participating in any dance classes, rehearsals, workshops, or performances. I agree to
indemnify, defend, and hold harmless Maddox Dance Company, employees and dance teachers for liabilities,
costs and judgments arising from acts of omissions committed by me or my child which result in injury or damage
to any person or property.

I would like to receive emails from Maddox Dance Company about reminders, class information and upcoming events.