I am aware and fully understand that there are risks and dangers associated with participation in dance classes, which may include Zumba, Ballet, Tap, Jazz, Lyrical, Hip Hop, Modern and different dance movements of the varied dance disciplines. These movements and activities could result in bodily injury, partial or total disability or death. The social and economic losses/or damages which could result from these risks and dangers could be severe. I acknowledge that students will be physically touched from time to time during his/her dance training and instruction and I will not hold Expressions Dance and Fitness liable for such physical touching. I understand that these risks and dangers may be caused by the negligence of the participant or the negligence of others. There may be risks not known to us or are not foreseeable at this time.
I accept and assume all such risks and responsibilities for the lessees and/or damages following such injury and/or disability however caused or alleged to be caused in whole or in part by the negligence of Expressions Dance and Fitness, its instructors, independent contractors, hosts, other participants/students, sponsors, advertisers, owners, officers and lessees of the premises used to conduct the event or activity and each of them, their officers, directors, agents and employees. I agree that this consent and assumption of risk statement covers each and every event or activity sponsored by Expressions Dance and Fitness.
Consent for Emergency Treatment: In cases of emergency Expressions Dance and Fitness is authorized to arrange for medical services for the student and I consent to appropriate medical and surgical service recommended by licensed medical professionals. I accept full responsibility for all costs of said medical care and any emergency treatments.
Expressions Dance and Fitness will not be responsible for the cost of any medical care or emergency treatments. I hereby waive all claims whatsoever in connection with such medical treatments. I agree that Expressions Dance and Fitness will not be held liable for and agree to hold Expressions Dance and Fitness harmless from any and all liabilities, losses, damages or expenses related to the student’s participation in any activities at Expressions Dance and Fitness Classes.
I HAVE READ THE ABOVE WAIVER AND SIGN IT VOLUNTARILY. I HAVE READ THE STUDIO POLICIES AND UNDERSTAND THAT FAILURE TO ABIDE BY THESE POLICIES AND STANDARDS SET FORTH MAY REQUIRE DISMISSAL FROM THE STUDIO.
I ______________________________________________ (Name of participant or parent/guardian of participant), hereby represent to Expressions Dance and Fitness that I, or my child______________________________________ is of sound health and has no history of a medical or physical condition which could in any shape, manner or form place me, or my child at risk because of said condition. I also acknowledge that I have been informed by Expressions Dance and Fitness of the nature of the instruction my child will receive and that such instruction involves physical exercise and stress, which could result in injury and /or disability.
Name of Participant: (print please)
Parent/Guardian (if under 18 years) :
Signature: ______________________________________________Cell #: ____________________