Nov 30, 2021 09:06 PM


Program/ Activity: Dancing School

In consideration of C.A. Dance Xpress Inc and Dance Xpress New Jersey Inc permitting

(Student name):_________________________________________________ to participate in the program/activity indentified above, the undersigned parent(s) legal guardian(s) of Participant hereby freely agree(s) to and make(s) the following contractual representations and agreements:

I agree that it is my sole responsibility to be familiar with the physical and/or mental demands on the Participant that may be associated with this program/activity. With these demands in mind, Participant has no physical or medical condition which, to my knowledge, would endanger Participant or others participating in this program/activity, or would interfere with Participant’s ability to participate in this program/activity. I also agree that Participant shall abide by any established rules/regulations while in this activity.

I understand that situations may arise during the program/activity which may be beyond the control of the Releasees (defined below). I fully realize the risks and dangers to Participant associated with participation in a program/activity of this type and voluntarily assume all such risks and dangers, whether or not known or reasonably foreseeable at this time. I understand the risks and dangers include, by the way of example and not by limitation, bodily injury disability and/or death that may result from participation in the program/activity, and resulting social and economic losses and/or damages.

I hereby agree not to sue the Dance Studio, its owners, directors, officers, managers, employees, agents, guests, invitees, assigns or other participants in the program/activity (collectively the “Releasees”) and release and forever discharge Releasees from all liability to Participant ( and to the undersigned parent(s) or legal guardian(s) of Participant), my/our personal representatives, assigns, executors, heirs and next of kin and waive any and all claims and demands for losses and damages on account of any injury, including but not limited to the death of the Participant, or damage to property however caused, even if occasioned by or proximately caused by negligence on the part of the Releasees or otherwise.

I agree for myself and my successors, assigns, beneficiaries, executors, and my personal estate, that the above representations and agreements are contractually binding and are not mere recitals. I agree that my failure or refusal to sign other such agreements or releases shall in no way affect the validity of this agreement nor revoke or cancel any of the terms hereof. I and my successors shall be liable for all expenses (including legal fees) incurred by the Releasees in defending any claim or suit brought in violation of this agreement. This agreement may not be modified orally, shall by governed by, and is and is intended to be as broad and inclusive as is permitted under, the laws of the State of New York. If any provision of this agreement is held invalid it is agreed that the balance shall notwithstanding continue in full force and effect.

I, as parent/guardian of the above-named minor Participant, hereby give my permission for my child/ward to participate in the above-named program/activity, and further agree by signing below, individually and on behalf of my child/ward, to the terms of this agreement.

PARENT/GUARDIAN SIGNATURE: _________________ DATE: ________