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THE DANCE SHOPPE 3316 W. BELL RD. #D, PHOENIX, AZ. 85053
Risk and Release
I understand that it is the express intent of The Dance Shoppe to provide for the
safety and protection of me and/or my child(ren). In consideration for allowing me
and or my child(ren) to use these facilities, I hereby forever waive and release The
Dance Shoppe, its officers, employees, teachers and agents, from all liability for
any and all damages and injuries suffered by me and or my child(ren) while under
the instruction, supervision, or control of The Dance Shoppe.
I confirm that the named persons below are in good health and have no known
physical impairments that would cause harm to the named persons below by
participation in this program.
I also agree to individually provide for the possible future medical expenses which
may be incurred by my child(ren) or me while taking classes, training at, or
performing for The Dance Shoppe.
I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk
that my child(ren) and I may be exposed to or infected by COVID-19 by attending
The Dance Shoppe in-person classes, and that such exposure or infection may
result in personal injury, illness, permanent disability, and death. I voluntarily
agree to assume all of the foregoing risks and accept sole responsibility for any
injury to my child(ren) or myself, including illness, death, damages, loss, claim,
liability or expense of any kind, that I or my child(ren) may experience or incur in
connection with my child(ren)’s attendance at The Dance Shoppe. On my behalf,
and on behalf of my children, I therefore hereby release, covenant not to sue,
discharge, and hold harmless The Dance Shoppe, its employees, agents and
representatives, of and from all claims to the extent permitted by law.
I give permission to use photography and recording of my child in advertisement
and or social media
By signing I agree that me or my child(ren) is/are NOT experiencing the following
symptoms before coming to dance class:
▪ No fever for 2 weeks
▪ No cough
▪ No cold/flu symptoms such as chills, muscle pain, headache or sore throat
▪ No shortness of breath
▪ No loss of smell/taste
▪ No positive COVID-19 test
▪ No close contact with someone who tested positive for COVID-19
Parent _______________________________- date _______________
Student signature if 18+ years old
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