Liability & Medical Release Agreement


Mar 01, 2021 07:57 PM



Jackson School of the Arts
Agreements in consideration for my child being permitted to participate in Jackson School of the Arts dance programs.

I/we, parent(s) and/or legal guardian(s) of a student enrolled at JSA, agree to the following provisions:

Acknowledgment of Risks: I/we understand that there are numerous risks associated with participating in dance and arts activities, including those risks present during classes and activities, on the premises before, during, and after various classes and events. Some of the specific dance/movement risks include the placement of unusual stresses on the body, falls and tripping which may lead to accidents resulting in, but not limited to, mild to severe bodily injury.

I/we understand that JSA cannot be responsible for any injuries or damages experienced by my/our child during her/his participation in Jackson School of the Arts activities.


I/we have read and clearly understand the terms of this agreement. I/we give my/our permission for my/our child to participate in all JSA activities. I/we also release and hold harmless the JSA, its officers, directors, agents and employees, and those acting under its authority, from all actions, claims and liabilities relating to my/our child’s participation in any and all programs. I further agree to indemnify and hold harmless and defend JSA Staff and Board of Directors, its teachers, officers, agents, and employees from injuries, damages and losses sustained by me or my child arising out of, connected with, or in any way associated with the activities of the program(s).

Medical Care: In an emergency situation, when parental permission is not available, I/we hereby grant and give my/our permission for a staff member at JSA to seek emergency medical treatment for my/our child. In my/our absence or inability to communicate with emergency and hospital personnel, I/we hereby grant JSA authority to release for the purposes of providing medical treatment, my/our child to the care of medical personnel or physicians as the JSA determines as reasonably appropriate.
Media Relations: I/we consent and give permission to JSA, to use the name or likeness of my child for the purpose of marketing of JSA to the public though print and social media. If I do not give consent I will notify JSA staff by completing a form.