Release and Waiver of Liability and Indemnity Agreement and Media Release
(Read Carefully Before Signing)
In consideration of being permitted to participate in any way in the Dance Program indicated below and / or being permitted to enter for any purpose any restricted area (here in defined as any area where in admittance to the general public is prohibited), the parent(s) and / or legal guardian(s) of the minor participant named below agree:
1.) The parent (s) and / or legal guardian(s) will instruct the minor participant that prior to participating in the below dance activity or event, he or she should inspect the facilities and equipment to be used, and if he or she believes anything is unsafe, the participant should immediately advise the officials of such condition and refuse to participate. I understand and agreed that if at any time, I feel anything to be unsafe, I will immediately take all precautions to avoid the unsafe area and refuse to participate further.
2.) I / We fully understand and acknowledge that:
(a) There are risks and dangers associated with participation in Dance events and activities which could result in bodily injury partial and / or total disability, paralysis and death.
(b) The social and economic losses and / or damages, which could result from these risks and dangers described above, could be severe.
(c) These risks and dangers may be caused by the action, inaction or negligence of the participant or the action, inaction or negligence of others, including , but not limited to , the Releasees named below.
(d) There may be other risks not known to us or are not reasonably foreseeable at this time.
3.) I / We accept and assume such risks and responsibility for the losses and / or damages following such injury, disability, paralysis or death, however caused and whether caused in whole or in part by the negligence of the Releasees named below.
4.) I / We hereby release, waive, discharge and covenant not to sue the dance facility used by the participant, including its owners, managers, promoters, lessees or premises used to conduct the dance event or program, premises and event inspectors, underwriters, consultants, and others who give recommendations, directions or instructions to engage in risk evaluation or loss control activities regarding the dance facility or events held at such facility and each of them , their directors, officers, agents, employees all for the purposes herein referred to as “Releasee” from all liability to the undersigned, my / our personal representatives, assigns, executors, heirs and next of kin for any and all claims, demands, losses or damages and any claims or demands therefore on account of any injury including but not limited to the death of the participant or damage to property, arising out of or relating to the event(s) caused or alleged to be caused in whole or in part by the negligence of the releasee or otherwise.
5.) I / We hereby acknowledge that the activities of the event(s) are very dangerous and involve the risk of serious injury and / or death and / or property damage. Each of the undersigned also expressly acknowledges that injuries received may be compounded or increased by negligent rescue operations or procedures of the releasees.
6.) Each of the undersigned further expressly agrees that the forgoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as it permitted by the law of the Province or State in which the event is conducted and that if any portion is held invalid, it is agreed that the balance shall, notwithstanding continue in full legal force and effect.
7.) On behalf of the participant and individually, the undersigned participant(s) and / or legal guardian(s) for the minor participant executes this waiver and release. If, despite this release, the participant makes a claim against any of the releasees, the parent(s) and / or legal guardian(s) will reimburse the releasee for any money which they have paid to the participant, or on his behalf, and hold them harmless.
The undersigned agrees and consents to the filming, videotaping, photography or audio recording or other means of electronic, print or publication by Xtreme Dance Center Inc / Xtreme Dance Co. I agree to the use of my dancer/child's image or voice for preparation of training, educational, or promotional materials to assist with advertising and educational matters. I further agree that I shall expect no royalty payments, honoraria, appearance fees, nor shall I impose additional license or personal copyright conditions to the use of my image or voice, or that of my minor child. I also understand that any videos/images created by the organization may or may not contain first names to help promote not only the organization but my dancer and my dancer's individual goals that they may have.
I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.
This consent and release applies to the undersigned and the minor child identified below.
I have read and understand all studio policies.
Dance School: Xtreme Dance Center Inc.
Parent or Guardian Signature (if minor or Participants Signature if Adult)