| Dancer's Information |
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| Father's Information |
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| Mother's Information |
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| Emergency Contact Information |
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| Current/Former School Information |
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| Insurance Information |
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| Liability: I, the undersigned, understand that Dancing Arts Center, its teachers, directors, pianists, host families, and agents are not liable for personal injuries or loss or damage to personal property. Since dance is a physical activity, injuries may occur. Each student may decline to participate in any activity that may be harmful and is responsible for informing the instructor of any physical limitations that may prevent full
participation in class or related activities. I hereby release and hold harmless the Dancing Arts Center, its staff, volunteers, and host families from and against liability or claim for any injury, misadventure, harm, loss, cost, or damage sustained as a result of my childs participation in the Dancing Arts Centers classes and activities. |
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| Press and photography waiver: I, the undersigned, give Dancing Arts Center permissionin perpetuity and with no compensationto use any and all photographic images of the above-named dancer, including but not limited to participation in rehearsals and backstage performance environments, for the purpose of publicizing the schools performances in an medium whatsoever, including but not limited to publicity materials, retail products,
school publications, and school online literature and materials. |
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| Release for treatment: The staff of Dancing Arts Center has my permission to seek any necessary medical
or dental treatment for
*(Dancer Name)
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