Wade Dance Centre

I/we the undersigned parent(s) or legal guardian(s) understand that dance requires physical exertion. It is my/our responsibility to consult with a physician before participation in dance class, productions, programs or workshops, on or off the premises.

I/we realize that participation in dance classes and activities could involve possible personal injury. Despite precautions, accidents and injuries may occur. By signing this release form, I/we assume all risks related to the use of all spaces used by Wade Dance Centre.

I/we agree to release and hold harmless Wade Dance Centre including its teachers, dancers, staff and members and facilities used by both entities from any cause of action, claims, or demands now and in the future. I/we will not hold Wade Dance Centre liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes. Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behaviour in addition to any damage I/we may cause to the facilities utilized by Wade Dance Centre.

In the event that I/we should observe any unsafe conduct or conditions before, during or after my/our classes, I/we agree to report the unsafe conduct or conditions to the owner, instructor or staff members as soon as possible.

I give Belva Wade Zentner and Wade Dance Centre consent to use photographs taken for promotional purposes.

Signature

Dancer's Name

Dancer's Age

Parent/Guardian Name

Phone Number

Email Address

Dance Genres

FOR OFFICE USE ONLY

Paid By: 1st Term

Paid By: 2nd Term

Costume(s)

Your name:

Your email:

Your phone number:

Message: