Waiver/Liability
Oct 21, 2024 10:21 PM
PRIVACY
Studio V Dance Release From Negligence Form
Studio V Dance agrees to not release any information provided by you to any outside
organization without your consent.
In exchange for permission for me and/or for my child to participate in the Studio V Dance program and classes, I hereby grant the following release from liability on my own behalf and on behalf of my child. I, on my own behalf, and also as parent and/or guardian on behalf of the minor child identified below, release, discharge and hold harmless the Studio V Dance instructor, directors, landlords and sponsors (hereafter the “Released Parties”) from any and all liability for injury to my child’s person, my person or other persons, and to my child’s property, my property or other persons’ property, arising out of or in connection with, or caused in any manner by my participation or my child’s participation in the Studio V Dance program or
Classes. I acknowledge I hereby have been advised to consult, and have consulted, with my physician and/or with my child’s physician with respect to any past or present injury, illness, health problem or any other condition or medication that I and/or my child now have, previously have had and/or no way have that may affect my and/or my child’s participation and ability to participate in and to endure the Studio V Dance program and classes.
In the event that I and/or my child become ill or injured during or as a result of participation in the Studio V Dance program or classes, I hereby authorize the Released Parties to arrange for such emergency medical attention as they, in their sole judgment, may deem to be required to preserve my life and/or health and/or the life and/or health of my child, I hereby release, discharge and hold harmless the Release Parties, as well as any person or entity that provides such emergency medical attention, from any and all liability in connection with any injury to my or my child’s person or property arising in connection with or as a result of such
emergency medical treatment.
I authorize Studio V Dance to use my child’s image in photography and/or video for website, brochure, videos, or promotions. I understand that students will not be compensated in any way for the use of these images and the students’ names will not be used without additional consent.
I have read completely, understand fully and agree to the policies stated in the 2024-2025 Studio V Dance Handbook, including the tuition agreement. I understand that this registration is for the full dance season of September 2024-June 2025.