Dancer Registration Form

PYDF 2022 - Dancer Registration Form

Please complete the following form and submit no later than February 1st in order to participate in the Philadelphia youth Dance Fest 2022 Festival.
Participant Name *

First Name Last Name
Dance Studio *
Age *
Parent/ Guardian name (if a minor)

First Name Last Name
Parent/Guardian E-mail *
To be filled out by parent/guardian if student is a minor
Phone Number *

area code To be filled out by parent/guardian if student is a minor
Would you like to receive news and updates from PYDF throughout the year? *

YES NO
Emergency Contact *

First Name Last Name
Relation to participant *
Phone Number *

Area Code Phone Number
Please list any allergies/medical conditions PYDF should be aware of. *

PYDF T-shirt size - Each participant receives one free shirt! *

Extra Small Small Medium Large Extra Large

Participation Fee

Participation fee is $75.00 per dancer.

This fee is non-refundable unless PYDF cancels the festival due to COVID restrictions.

Participating dancers are required to pay this to their company directors who will in turn pay PYDF. Please speak with your company directors on how best to do this.

No individual student checks will be accepted by PYDF.
I have read and understood the payment methods for the PYDF Participation Fee and will submit my payment directly to my company director before February 1st, 2022

Waiver and Release of Liability

To be signed by participant or Parent/Guardian if participant is a minor.
Waiver and Release of Liability

IN CONSIDERATION OF the risk of contracting COVID-19 while participating in Philadelphia Youth Dance Festival during this Pandemic (hereinafter the “Activity”); and

IN CONSIDERATION OF my desire to participate in dance during said Activity and being given the right to participate in same;

I HEREBY for myself or my child(ren) (hereinafter collectively, “Releasor,” “I” or “me”, which terms shall also include Releasor’s parents or guardian if Releasor in under 18 years of age), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and hereby waive any and all rights, claims or causes of action of any kind arising out of my participation in the Activity: and

I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING, ATTENDING, AND PERFORMING AT PHILADELPHIA YOUTH DANCE FESTIVAL, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PHYSICAL INJURY, PAIN, SUFFERING, TEMPORARY ILLNESS OR DEATH DUE TO COVID-19. I UNDERSTAND THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS’ NEGLIGENCE, CONDITIONS RELATED TO TRAVEL TO AND FROM THE ACTIVITY, OR FROM CONDITIONS AT THE ACTIVITY LOCATION. NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME, OR MY PARTICIPATION IN THIS ACTIVITY.

I FURTHER AGREE to indemnify, defend and hold harmless the Releasees against any and all claims, suits, or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney’s fees and any related costs.

I FURTHER ACKNOWLEDGE that Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Releasees. In the event that I should require medical care or treatment, I AUTHORIZE Philadelphia Youth Dance Festival to provide all emergency medical care deemed necessary, including but not limited to first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.

I FURTHER ACKNOWLEDGE that I agree not to participate in Philadelphia Youth Dance Festival unless I am medically able and trained and agree to abide by the decision of the Philadelphia Youth Dance Festival Director regarding my approval to participate in dance classes.

I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS “WAIVER AND RELEASE” AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I WILL EXPRESSLY AGREE TO RELEASE AND DISCHARGE Philadelphia Youth Dance Festival AND ALL EMPLOYEES, FACULTY, VOLUNTEERS, STAFF, AND REPRESENTATIVES, FROM ANY AND ALL CLAIMS OF CONTACTING COVID-19 AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OPTHERWISE HAVE TO BRING A LEGAL ACTION AGAINIST Philadelphia Youth Dance Festival FOR PERSONAL INJURY OR DAMAGES OF ANY KIND.

To the extent that statute or case law does not prohibit releases for ordinary negligence, this release is also for such negligence on the part of Philadelphia Youth Dance Festival, its employees, faculty, volunteers, staff, and representatives.

I agree this this Release shall be governed for all purposes by Pennsylvania Law, without regard to any conflict of law principles. This Release is in addition to any general releases signed for participation and in the case where such release may conflict, this release shall supersede. No promises, guarantees, or agreements outside this and the general release exist.

THIS WAIVER AND RELEASE OF LIABILITY SHALL REMAIN IN EFFECT FOR THE DURATION OF MY PARTICIAPTION IN PHILADELPHIA YOUTH DANCE FESTIVAL 2022 DURING THE INTIAL AND DURATION OF THE COVID-19 PANDEMIC.

THIS AGREEMENT was entered into at arm’s length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both Participant, {name3} and Philadelphia Youth Dance Festival agree that this agreement is clear and unambiguous as to its terms, and that no other evidence shall be used or admitted to alter or explain the terms of this agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into.

In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase, or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect. If a court should find that nay provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed, and enforced as so limited.
PARENT/GUARDIAN WAIVER FOR MINORS

In the event that the participant is under the age of consent (18 years of age), then this release must be signed by a parent or guardian, as follows:

I HEREBY CERTIFY that I am the parent or guardian of {name3} and do hereby give my consent without reservation to the foregoing on behalf of this individual.
Name

First Name Last Name
Relationship to minor
Signature

Clear
Date

Month Day Year
Date
WAIVER FOR PARTICIPENTS 18 YEARS OF AGE & OLDER

I, THE UNDERSIGNED PARTICIPANT, AFFIRM THAT I AM OF THE AGE OF 18 YEARS OR OLDER, AND THAT I AM FREELY SIGNING THIS AGREEMENT. I CERTIFY THAT I HAVE READ THIS AGREEMENT, THAT I FULLY UNDERSTAND ITS CONTENT AND THAT THIS RELEASE CANNOT BE MODIFIED ORALLY. I AM WARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT THAT I AM SIGNING OR MY OWN FRE WILL.
Name

First Name Last Name
Signature

Clear
Date

Month Day Year
Date

Hold Harmless Release

In consideration of being provided the opportunity to participate in the Philadelphia Youth Dance Fest at Creative Edge Center for the Arts, in a dance festival directed by Melissa Chisena, I , {name3} / {name} , voluntarily agree to assume any and all risks which might be associated with this activity and I further agree to release, indemnify and hold harmless Creative Edge Center for the Arts, its officers, committee members, directors and agents and Melissa Chisena / Philadelphia Youth Dance Fest, from and against any claim which I or any other person representing me may have for any losses, damages or injuries arising out of or in connection with this activity including but not limited to any claim arising from my travel to or from the facility.

I have read and I understand the above release. I voluntarily agree to be legally bound by its terms.
Name

First Name Last Name
Signature *

(to be signed by parent/ guardian if a minor) Clear
Date

Month Day Year
Date

Should be Empty:

PYDF 2022 - Dancer Registration Form

Waiver and Release of Liability