I/we understand that there is a risk of potential injury associated with dance classes, rehearsals, and performances. I represent that the student/dependent minor I am registering is in good health and physically capable of participating in ballet/stretching/dance classes, rehearsals and performances. On behalf of myself and the registered student, I hereby waive and release any claim against the Scarsdale Ballet Studio, Diana White, the faculty, employees, and counselors of the Scarsdale Ballet Studio arising out of a personal injury occurring in connection with classes, rehearsals or performances or otherwise occurring in or around the ballet studio or other location of rehearsals or performances. I accept responsibility for obtaining appropriate accident, health, and hospitalization insurance to cover the student in the event of personal injury. In the event of injury or other medical emergency, if I cannot be reached, I authorize a representative of the Scarsdale Ballet Studio to seek any medical assistance reasonably required and I agree to be responsible for any medical expenses incurred on behalf of the student. I have read the above information and agreed to this release.

I give permission for images or film clips of my child to appear in advertising materials, publicity photos and/or on the website of the Scarsdale Ballet Studio.