I, , hereby grant and authorize House Of Modern Dance LLC/House Of Theatre LLC/Carmilla Peterson the right to take, edit, alter, copy, exhibit, publish, distribute and make sue of any and all pictures or video taken of me by House Of Modern Dance LLC/House Of Theatre LLC/Carmilla Peterson to be sue in and/or for legally promotional materials including, but not limited to, newsletters, flyers, posters, brochures, advertisements, fundraising letters, annual, reports, press kids and submissions to journalists, websites, social networking sites and other print and digital communications, without payment or any other consideration. This authorization extends to all languages, media, formats and markets now known or hereafter devised. This authorization shall continue indefinitely, unless I otherwise revoke said authorization in writing.
I understand and agree that these materials shall become the property of House Of Modern Dance LLC/House Of Theatre LLC/Carmilla Peterson and will not be returned.
I hereby hold harmless, and release House Of Modern Dance LLC/House Of Theatre LLC/Carmilla Peterson from all liability, petitions, and causes of action which I, my heirs, representative, executors, administrators, or any other persons may make while acting on my behalf or on behalf of my estate.
This form is excepted/signed by parent or guardian of minor participant.
IN CONSIDERATION OF the rise of injury that exists while participating in Dance or Theatre ( hereinafter the "Activity"); and
IN CONSIDERATION OF my desire to participate in said Activity and begin given the right to participate in same;
I HEARBY, for myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively, "Releasor," "I" or "me", which terms shall also include Releasor's parents or guardian if Releasor is under 18 years of age), Knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and herby waive any and all rights, claims or causes of action of any kind arising out of my participation in the Activity; and
I HEARBY release and forever discharge HOUSE OF MODERN DANCE LLC/ HOUSE OF THEATRE LLC/CARMILLA R PETERSON, Located at 126 N 3rd St Minneapolis MN 55446, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns (collectively "Releasees"), from any physical or psychological injury that I may suffer as a direct result of my participation in the aforementioned Activity.
I AM BOLUNTARILY PARICIPATING IN THE THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMORARY OR PERMANAENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS' NEGLIGENCE, CONDITION RELATED TO TRAVEL TO AND FROM THE ACTIVITY, OR FROM CONDITIONS AT THE ACTITIVITY LOCATION(S). NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY.
I FUTHER AGREE to indemnify, defend, and hold harmless the Releasees against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs,
I FURTHER ACKNOWLEDGE that Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf or Releasees. In the event that I should require medical care or treatment , I authorize House Of Modern Dance LLC/House Of Theatre LLC/Carmilla Peterson to provide all emergency medical care deemed necessary, including but not limited to , first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assume all cost involved and agree to be financially responsible for any cost incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.
I FURTHER ACKNOWLEDGE that this Activity may involve a test of person's physical and mental limits and may carry with it the potential for death, serious injury, and property loss. I agree not to participate in the Activity unless I am medically able and properly trained, and I agree to abide by the decision of the House Of Modern Dance LLC/House Of Theatre LLC/Carmilla Peterson official or agent, regarding my approval to participate in the Activity.
I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS "WAIVER AND RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE HOUSE OF MODERN DANCE LLC/HOUSE OF THEATRE LLC/CARMILLA PETERSON AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAINS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHTS THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST HOUSE OF MODERN DANCE LLO/HOUSE OF THEATRE LLC/CARMILLA PETERSON FOR PERSOANL INJURY OR PROPERTY DAMAGE.
To the extent that statue or case law does not prohibit releases for ordinary negligence, this releases is also for such negligence on the part of House Of Modern Dance LLC/House Of Theatre LLC/Carmilla Peterson. its agents, and employees.
I agree that this release shall be governed for all purposes by Minnesota Law, without regard to any conflict of law principles. This release supersedes any and all previous oral or written promises or other agreements.
In the even that any damages to equipment or facilities occurs as a result of my or my family's or my agents willful actions, neglect or recklessness, I acknowledge an agree to be held liable for any and all costs associated with any such actions of neglect or recklessness.
THIS WAIVER AND RELEASE OF LIABLITLIY SHALL REMAIN IN EFFECT \FOR THE DURATION OF MY PARTICIPATION IN THE ACTIVITY, DURING THIS INITIAL AND ALL SUBSEQUENT EVENTS OF PARTICIPATION.
THIS AGREEMENT was entered into electronically without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both Participant_______ and House Of Modern Dance LLC/House Of Theatre LLC/Carmilla Peterson agree that this agreement is clear and unambiguous as to it's terms, and that no other evidence shall be used or admitted to alter or explain the terms of this agreement, but that it will be interpreted based on the language in accordance with the purpose of which it is entered into.
In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the reminder of this agreement shall remain in full force and effect. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.
In the event of an emergency, please contact the following person(s) in order presented in the emergency contact fields in students profile.
In the event that the participant is under the age of consent (18 years of age), then this release must be signed by a parent or guardian, as follows:
I HEARBY CERTIFY that I am the parent or guardian of ______, named above, and do hereby give my consent without reservation to the foregoing on behalf of this individual.
Powered by: DanceStudio-Pro.com