WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT
This agreement is made and entered into as of the day of , , by and between the undersigned
(“Student”), and Fusion Dance & Performing Arts, LLC (“Fusion Dance” “Fusion Dance & Performing Arts”)
NOW, THEREFORE, in consideration of the mutual covenants and promises contained herein, the parties hereto
agree as follows:
Student hereby agrees to follow and abide by the policies and procedures of Fusion Dance & Performing Arts, a
copy of which has been received. Student further understands that Fusion DPA may refuse admittance or
instruction to any student that has violated the policies and procedures of Fusion DPA and further understands
that Fusion DPA has sole discretion to make decisions regarding programs, and participation of students in said
programs.
In consideration of Fusion DPA accepting Student's enrollment in classes, Student hereby, for myself, my
parent(s)/guardian(s), my family, heirs, or assigns and/or for the minor for whom I am signing, agree to the
following:
1. It is Student's intention to exempt and release Fusion DPA from all liability whatsoever for personal illness,
injury, damage to Student's property, or wrongful death arising out of or in the course of Student's participation
in dance classes or programs.
2. Student hereby affirms that Student has been well advised and thoroughly informed of the inherent hazards
and policies of the dance classes or programs. Student knows that participating in dance classes or programs
could be potentially hazardous, and Student should not participate unless Student is medically able. Student
personally assumes all risks associated with Student's voluntary participation in any dance class or program for
any harm, injury or damage that may befall Student as a result of Student's participation, whether foreseen or
unforeseen.
3. Student hereby agrees that Fusion DPA shall not be liable in any way for any occurrence in connection with
Student's participation in any dance class or program, that may result in illness, injury, death, or other damages
to Student or Student's property, and in consideration of being allowed to participate in the dance class or
program, Student hereby personally assumes all risks and expenses in connection with said dance class or
program for any harm, injury, or damage that may befall Student, including all risks connected therewith,
whether foreseen or unforeseen; and further to save and hold harmless Fusion DPA, and its members, managers,
officers, employees, and agents from any claim by Student, or Student's parent(s)/guardian(s), family, estate,
heirs, or assigns arising out of Student's participation in the dance class or program.
4. Assuming all other conditions are met, Fusion DPA will not refuse participation by anyone due to race, color,
creed, national origin, sex, or age.
5. Student further acknowledges that any photographs or visual recordings of Student's performance are for
Student's own personal use and enjoyment, and shall not be disclosed to any other dance studio, nor shall
Student have any right, title, or interest or any kind or nature in proceeds derived from the sale of the same.
6. Student hereby allows Fusion DPA to use photographs and video recordings of Student for advertising
purposes and promotions.
7. This Agreement shall be constructed, construed, and enforced in accordance with the laws of the State of Iowa.
Each of the parties consents to the jurisdiction of the Iowa District Court for Black Hawk County in all matters
relating to this Agreement. The prevailing party in any action to enforce this Agreement shall be entitled to
reasonable attorney fees and costs.
By agreeing below, I am confirming that I have had sufficient opportunity to read this entire document. I have read
and understood it, and I agree to be bound by its terms.
