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Liability Waiver Form
I/we realize that participation in dance classes and activities could involve some possible personal injury. Despite precautions, accidents and injuries may occur. By signing this release form, I/we (the dancer and parent/guardian) assume all risks related to the use of any and all spaces used by York Dance Center.
I/we agree to release and hold harmless York Dance Center, Jodie Blase, dancers, staff members, and facilities used from any cause of action, claims, or demands now and in the future. I/we will not hold York Dance Center liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes. Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by York Dance Center.
In the event that I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.
Dancer’s Name: _____________________________________________ Age: _______________________________________
Dancer’s Signature: __________________________________________ Date: ______________________________________
(If unable to sign, parent/guardian sign only)
Parent/Guardian Name: ______________________________________ Phone: _____________________________________
Parent/Guardian Signature: __________________________________ Date: ______________________________________
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