We need you to answer this to make sure you are a person and not spam.
You must have read the Rules & Tuition Policies 2017 and agree to all the waivers included in the form.
PHOTO/IMAGE RELEASE: I give my consent for images (photographs/video) of myself or my dependent to be taken and used to document the activities of Heartland Dance Studio. I grant Heartland Dance Studio permission to use the images for educational and promotional purposes, including social media outlets. I understand that if I do not want images of my dependent to be used, I will indicate this by clicking the check mark on the registration form and bringing in a note to the studio.
MEDICAL RELEASE: In case of emergency, if none of the above can be contacted, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent. I accept full responsibility for all costs of said medical care and any emergency treatments. Heartland Dance Studio will not be responsible for the cost of any medical care or emergency treatments. I hereby waive all claims whatsoever in connection with such medical treatments.
WAIVER AND RELEASE: I agree that if my dependent or I (heretofore known as “we”) engage in any physical exercise, class, or activity, or facility on the premises or any venue where we participate as representatives of Heartland Dance Studio, we do so at our own risk. I agree that we are voluntarily participating in activities and use of said facilities, premises (including the parking lot) and designated Heartland Dance Studio venues. We assume all risk of injury, illness, damage, or loss to us or our property that might result, including, without limitation, any loss or theft of any personal property. I agree that this consent and assumption of risk statement covers each and every event or activity sponsored by Heartland Dance Studio. I agree to release and discharge you (and your affiliates, employees, agents, representatives, successors, and assigns) from any and all claims or cause of action (known or unknown) arising out of your negligence. I acknowledge that I have carefully read this Waiver and Release and fully understand that it is a release of liability. I am waiving any right that I may have to bring legal action to assert a claim against you for your negligence.
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