ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
Apr 28, 2024 04:16 PM
2023-2024 ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM for Ozark Dance and Fitness Center
PLEASE PRINT—You must fill out the form completely.
DATE: ____________________, 20____
Participants Full Name (1) _______________________________________Age __________
Participants Full Name (2) _______________________________________Age __________
Participants Full Name (3) _______________________________________Age __________
Parents Full Name ____________________________________________________________
Emergency Name/Phone _____________________________________________________
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN THIS ACTIVITY OR EVENT, including
by way of example and not limitation, any risks that may arise from negligence or carelessness on the
part of the persons or entities being released, from dangerous or defective equipment or property owned,
maintained, or controlled by them, or because of their possible liability without fault.
I certify that I am physically fit, have sufficiently prepared or trained for participation in the activity or
event, and have not been advised to not participate by a qualified medical professional. I certify that there
are no health-related reasons or problems which preclude my participation in this activity or event.
I certify that I am in good health and that I do not pose a health risk to the public.
I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders,
sponsors, and organizers of the activity or event in which I may participate, and that it will govern my
actions and responsibilities at said activity or event. In consideration of my application and permitting me
to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin,
successors, and assigns as follows:
I HEREBY WAIVE, RELEASE, AND DISCHARGE Ozark Dance and Fitness Center and all divisions
thereof of any and all liability and responsibility for injuries, sickness, pandemics, accidents, natural
disasters and/or acts of God incurred during participation in and/or instruction of camps, private lessons,
or any activity I may participate.
I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability
arising from the negligence or fault of the entities or persons released, for my death, disability, personal
injury, property damage, property theft, or actions of any kind which may hereafter occur to me including
my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: Ozark Dance & Fitness
Center and their employees, volunteers, or the activity or event holders, activity or event sponsors, activity
or event volunteers.
I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in
this waiver, release and registration form from any and all liabilities or claims made as a result of
participation in this activity or event, whether caused by the negligence of release or otherwise. The
accident waiver and release of liability shall be construed broadly to provide a release and waiver to the
maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM
AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN
FREE WILL. PARENT / GUARDIAN WAIVER FOR MINORS
(Only if student is under 18 years old) The undersigned parent and natural guardian does hereby represent that
he/she is, in fact, acting in such capacity, has consented to his/her child or ward’s participation in the activity or event,
and has agreed individually and on behalf of the child or ward, to the terms of the accident waiver and release of
liability set forth above. The undersigned parent or guardian further agrees to save and hold harmless and indemnify
each and all of the parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be
imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on
behalf of the minor, the parents, of the legal guardian. Participant’s Signature (if under 18 yrs old, Parent or guardian
must sign) ______________________________________________ Date Signed________________________
Signed for participant(s) listed above for the year of 2022.