Medical/Liability Waiver 23/24
Apr 26, 2024 01:05 PM
I am acknowledging below that i have signed and understand all liability/medical waivers and policies for my dancer at this studio. All information is listed below for reference.
I grant permission to the staff of Expressions Dance Studio to take first aid or emergency measures as judged necessary for the care and protection of my child while under the supervision of the studio while in or outside of the studio premises. In case of a medical emergency, I understand that my child will be transported to an appropriate medical facility by the local emergency unit for treatment if the emergency unit deems it necessary. I understand that in some medical situations the staff will need to contact the emergency resource before the child’s parent, physician, and or other person acting on the parent’s behalf. I understand the studio will contact the first phone number listed on the account (The call/text number) and then will follow with any in order on the list of contacts until someone has been reached. I also understand and agree that the child’s parents or legal guardians shall be responsible for any expenses incurred. I understand that this form is different than the liability/at risk waiver for the studio and that this form must be updated each year with our registration information and that my child may not be able to attend the studio or an event that a parent/guardian is not present until it is signed in person and that this form is scanned into our password protected online drive account to have on hand at events. Im aware that I can request a copy of this form at anytime.Our studios always have a minimum of 1 staff member (generally all) that are CPR and first aid certified on site.
For students age 12 (we absolutely will not allow under 12 anything that is ingested medication) and above may ask for tylenol/ibuprofen if they are in class more than 2 hours of the complaint. There must be a physical sign of discomfort for us to administer. If you would like to allow the studio to issue tylenol in the case of aches/pains, headache etc.. please check this box. Otherwise, please leave this box blank and your child will not be given any tylenol or medicines that would follow suit.
We have a first aid box at every studio for minor occurrences, however we need your consent to allow them use of these items (ice packs, neosporin, bandages, etc..) Please click this box if you would like to allow the studio to use these items in case of a minor incident if need be. Otherwise, please leave blank and your child will receive no additional minor first aid care. If your child has any medical/first aid allergies, please list them here; should your child's allergies change, please remember to update our records:
In case of an emergency, the following information could be needed and will be used if need be.
ACKNOWLEDGMENT OF RISK AND WAIVER OF LIABILITY
I acknowledge and agree that in participating in any dance class, workshop, rehearsal or performance, there is an inherent risk of physical injury or death. By signing this form, I voluntarily agree and consent to assume all risks and responsibility for any such injury or accident, which might occur to me, my child, or the minor child for whom I am a legal guardian of during any of Expressions Dance Studio LLC’s classes, rehearsals, performances, or activities. I (on behalf of myself, child, or the minor child for whom I am legal guardian), my heirs, executors, agents, assigns, and representatives, further agree to release, exempt, indemnify, and hold harmless Expressions Dance Studio LLC, its owners, agents, volunteers, instructors, assistants, employees, dancers, staff members, students, and facilities from any and all claims of liability arising from any accident, personal injury, death, property loss, or property damage sustained by myself, my child, or the minor child for whom I am a legal guardian. I will not hold Expressions Dance Studio LLC liable for any personal injury or any personal property damage that may arise out of or in connection with participation in any classes or activities conducted by Expressions Dance Studio LLC. I consent to have my child, myself, or the minor child for whom I am a legal guardian, participate in the programs and activities offered by Expressions Dance Studio LLC, and I accept full responsibility for the cost of any medical treatment to my child, myself, or the minor child for whom I am a legal guardian that may arise out of or in connection with participation in any classes or activities conducted by Expressions Dance Studio LLC. By signing this statement, I declare that the participant is in good health, with no physical conditions that might prevent his/her/my participation in strenuous and rigorous dance activities, training, and/or performance.