Apr 21, 2021 06:00 PM



I, as the undersigned person, parent or legal Guardian has chosen to participate in, or have their child participate in, dance instruction given by The School of Ballet Indiana, LLC (the “Company”), and the undersigned expressly gives permission for such dance instruction. I acknowledge and understand the nature of the activities that I or my child will be participating in and that I am or my child is in proper physical condition and capable of participating in the related activities, understanding that the Company is not in any way responsible for making such a determination.

I understand and agree on behalf of myself and if applicable, also my child, to RELEASE and DEFEND, INDEMNIFY, AND HOLD HARMLESS the Company, its owners, instructors, employees, independent contractors, landlord(s), volunteers, assistants, or other students from all claims, actions, demands, costs, liabilities, expenses or judgements, whether arising out of the Company’s negligence or not and whether foreseeable or unforeseeable, including but not limited to attorneys’ fees and court costs, for any occurrences arising out of or related to dance instruction or any other activities conducted by the Company or at the Company’s place of business.

I understand that the Company is not responsible for my child or other children under my supervision who are left unsupervised in the common areas and areas surrounding the studio and that the Company will only be supervising my child when he or she is participating in scheduled activities, programs, and instruction. Nothing contained in this paragraph shall affect the agreement set forth in the immediately preceding paragraph.

I understand that the Company is not responsible for personal property that is lost, damaged, or stolen while I am or my child is at or in the Company’s place of business.

I acknowledge and agree that it is my responsibility to maintain my own accident and health insurance coverage providing adequate coverage for myself and/or my child participating in Company activities and that the Company does not provide accident or health insurance for those participating in its instruction, activities, or programs. In the event that the parent/contact cannot be reached in an emergency, I give permission to the Company to render First Aid, as well as being taken to an emergency room or to call an ambulance to secure medical treatment, as needed.

I authorize and agree that the Company may take and use photographs, videos or likenesses of myself or my child for its record-keeping, advertising and/or public relations projects and that I have no rights to the same and will not be compensated for the same.

The Checked Box is proof of my intention to execute a complete and unconditional waiver and release of all liability pursuant to the terms herein. I am of lawful age and competent to sign this affirmation. If I am signing for my children, I certify that I am the parent or legal guardian and have right to waive these rights.