LIABILITY RELEASE/WAIVER FORM

All participants MUST complete this form

All parents or guardians must complete this form before your child can participate in any classes at K.P’s Dreams Dance Academy. By completing resignation, you are agreeing to the following:

Waiver of Liability

I, __________________________, the parent or guardian of _____________________ recognize and understand the risks of physical injury inherent to dance and dance training and I fully assume those risks. I hereby release Kyrsten Procyk, employees and dance teachers from all liability for injuries sustained or illnesses contracted while attending or participating in any dance classes. I agree to indemnify, defend, and hold harmless Kyrsten Procyk, employees and dance teachers for liabilities, costs and judgments arising from acts of omissions committed by me or my child which result in injury or damage to any person or property.

Initials:_____________

Protection of Property

I understand and agree that it is my sole responsibility to safeguard my personal property while attending or participating in any classes. I hereby release Kyrsten Procyk, employees and dance teachers from all liability for loss or damage to my personal property while attending or participating in classes. I also agree to abide by any rules, regulations and policies set forth by Kyrsten Procyk.

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Medical Attention

In case of physical injury or medical emergency, I hereby authorize Kyrsten Procyk to make necessary arrangements to transport my child to a medical treatment facility as necessary. All such transportation and medical treatment will be at my sole cost and expense. In extreme emergency, I understand that Kyrsten Procyk will attempt to notify the person(s) I have named below as my emergency contact(s) of my condition and how to reach me.

Initials:_____________

Photo Release

K.P’s Dreams Dance Academy reserves the right to use photographs and videos taken during classes, for the purposes of instruction, advertising and promoting K.P’s Dreams Dance Academy. Students, or parents of students who are minors, who do not wish to comply with this policy must notify Kyrsten Procyk prior to participation in class.

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No Refund Policy

K.P’s Dreams Dance Academy will not issue any refunds after dance lessons have begun. In signing this Release, I acknowledge and will not request a refund if my dancer wishes to drop out, gets kicked out based on behavior or has to end the season early.

Initials:_____________

Acknowledgement of Waiver

In signing this Release, I acknowledge and represent that I have fully informed myself of the content of the waiver and hold harmless agreement by reading it before I sign it, and I understand that I sign this document as my own free act and deed; no oral representations, statements, or inducements, apart from the written statement, have been made. I further state that I am at least eighteen (18) years of age and am fully competent to sign this agreement; and that I execute this release for full, adequate, and complete consideration fully intending to be bound by the same. I further state that there are no health-related reasons or problems which preclude or restrict my child’s participation in this camp, and that I will pay any medical costs that may be attendant as a result of injury to my child.

Initials: _____________

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