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Participant Waiver

Extensions School of Dance
Waiver and Release of Liability
Refund and Cancellation Policy
And Appearance Agreement


I, the undersigned, represent, acknowledge and accept that participation in the activities for which the Participant is registered includes strenuous physical activity and involves foreseeable risks of injury with or without the negligence of others. Participant, on his or her behalf, and the parent/guardians, on behalf of Minor Participant as well as on their own behalf, unequivocally agree to incur and assume such risks as a condition to participation in the activities for which Participant is registered.

In order to induce Extensions School of Dance and in partial consideration for Participant’s opportunity to participate, the Participant (and the Minor Participant’s parents/guardians on behalf of Minor Participant and on their own behalf) hereby waive all claims (past, present or future) and the hosting site on whose premises the event will be held (hereinafter collectively “Releasees”) from any and all liability, loss, cost, expense, claims, demands, actions, judgments and executions which the undersigned ever had, now has, or which the undersigned may have in the future, for personal injuries, known or unknown, and damage to property (real or personal) in any way caused by, related to, or arising out of, directly or indirectly, the activity for which Participant is registered or in which Participant is permitted to engage, in the event of illness or injury. I authorize Extensions School of Dance to obtain necessary medical treatment for the Participant and hereby, on my own behalf and on behalf of the Participant, release and hold harmless all Releasees. The undersigned represents and agrees that this waiver and release is binding not only on the undersigned, but also upon their respective heirs, representatives, administrators, executors, and assigns. This release covers every possible injury or accident of every sort and nature, whether related to the permitted activity, the equipment, the condition of the premises, or otherwise, and regardless of whether due in whole or in part to the negligence of a release or other Participant.

In addition, if anyone (whether a Participant, Minor Participant’s parent/guardian, or anyone else on behalf of a Participant or parent/guardian) makes a claim against any of the Releasees despite their release, then the undersigned agree to indemnify and hold harmless, each of the Releasees from any litigation expenses, attorney fees, loss, liability, damages or cost any releasee may incur as the result of any such claim.

The undersigned represent that the Participant is healthy and has no physical or mental condition that would impair Participant’s ability to fully and safely participate in the contemplated activity.

I, the undersigned, represent, acknowledge and accept that there are no refunds on any fees, for any reason, other than the event being canceled by Extensions School of Dance. I also understand that all checks returned from financial institutions will incur an additional $35 charge. All credit card reversals will incur an additional 2.5% charge of the original transaction. If outstanding invoices are sent to an outside collections agency the invoiced will incur penalties up to 25% of the original invoice or the maximum permitted by state law. Future payments will only be accepted by cashier’s check or money order.

I understand that Extensions School of Dance, from time to time produces promotional and other materials relating to its programs. I understand that as a participant in and/or a spectator at the event the participant may be included in videotapes, DVDs, and/or photographs taken during the Event. Therefore, without reservation or limitations, I, on my own behalf and on behalf of the Minor Participant, hereby assign, transfer and grant to Extensions School of Dance, its successors, assignees, licensees, sponsors and all other commercial exhibitors the exclusive right to photograph and/or videotape the Minor Participant and to utilize such videotapes and photographs in advertising.

I represent that any medication to which Participant is allergic or is currently taking are listed below. I agree the Participant shall bring medications which he/she is currently taking with him/her to the Event and that he/she shall consume the prescribed dosage.


I, in my own behalf and on behalf of the Participant, hereby warrant that I have read this form in its entirety and fully understand its contents and are voluntarily signing the same. I, in my own behalf and on behalf of the Participant, am aware that this Release and Waiver releases Releasees from liability and contains an acknowledgement of my voluntary and knowing assumption of the risk of injury or illness. I, in my own behalf and on the behalf of the Participant, further acknowledge that nothing in this document constitutes a guarantee that the Event will occur.