Participant Information:
 Name: ________________________________
 Address: ____________________________________________________________________________


Phone: _______________________________
Email: _______________________________

1. Assumption of Risk

I the undersigned participant, acknowledge that participation in dance classes and social events involves physical activity that carries inherent risks, including but not limited to physical injury, slips, trips, falls, and exposure to other participants. I voluntarily assume full responsibility for any risks of injury or harm that may arise from my participation.

2. Medical Clearance

I certify that I am physically fit, have no medical conditions that would prevent my participation, and have consulted a physician if necessary. I understand that it is my responsibility to inform the instructor or event organizer of any limitations or medical conditions.

3. Release of Liability

I release and discharge [Instructor/Studio/Event Organizer Name] and its employees, agents, volunteers, and representatives from all liability, claims, demands, and causes of action arising from my participation in this event, whether caused by negligence or otherwise.

4. Media Release

I grant permission for [Instructor/Studio/Event Organizer Name] to photograph or record me during the event and use these images for promotional purposes, including on websites and social media.
☐ Yes ☐ No

5. Code of Conduct

I agree to respect the instructors, participants, and venue. I understand that disruptive, unsafe, or inappropriate behavior may result in my removal from the event without a refund.

6. Indemnification

I agree to indemnify and hold harmless [Instructor/Studio/Event Organizer Name] from any claims, liabilities, or damages arising from my actions or participation in the event.

7. Emergency Contact

Name: _______________________________
Phone: ______________________________

Acknowledgment and Agreement
I have read and understand this waiver and voluntarily agree to its terms. I certify that I am at least 18 years old, or I have obtained parental/guardian consent if under 18.

Signature: ___________________________ Date: _______________


(Parent/Guardian Signature if under 18): ______________________

Printed Name: ________________________

WAIVER AND RELEASE OF LIABILITY


For All Dance Class and Social Event