Student Waiver & Release of Liability
• Fever • Fatigue • Dry Cough • Difficulty Breathing
• I agree if my child is sick they will not come to class.
I HEREBY ASSUME ALL OF THE RISKS OF receiving services at this establishment. I am aware of the inherent risks and I hereby proceed fully advised of the potential harm. Pat Brown School of Dancing intends to comply with CDC and Local recommendations, but cannot guarantee sanitation will prevent transmission.
In consideration of receiving services, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the unattended negligence or fault of the entities or persons released, for illness, disability, personal injury, and possible death or actions of any kind which may hereafter occur to me regarding THE FOLLOWING ENTITIES OR PERSONS: Pat Brown School of Dancing; Pat Brown and Teachers, Staff.
I CERTIFY THAT I HAVE READ THIS SECTION AND I FULLY UNDERSTAND ITS CONTENT.
Release of Liability
As I the legal parent or guardian, I release and hold harmless Pat Brown School of Dancing, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Pat Brown School of Dancing, its owners and operators or in route to or from any of said premises.
Medical Emergency
The undersigned gives permission to Pat Brown School of Dancing, its owners and operators to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I hereby declare any physical/mental problems, restrictions, or condition and/or declare the participant to be in good physical and mental health. I request that our doctor/physician be called and that my child be transported to hospital.
Photo Release
Photo Release: I give permission to Pat Brown School of Dancing to take photos of my child to use in brochures, studio web site, posters, advertisements, or other promotional material. I understand their names will not be used.