Ballet Tech Alumni Class Liability Waiver

Ballet Tech Alumni Classes

Please use this form to participate in Ballet Tech alumni dance classes.
Name of Participant*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Are you 18 years or older?*

YESNO

Please have parent read & sign this form.
Parent/Guardian Name*

First NameLast Name
Participant's Date of Birth*

MonthDayYear
Date
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.

Liability Waiver
WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK

AND INDEMNITY AGREEMENT

I, _______________________, HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH or AT Ballet Tech Foundation Inc (890 Broadway, NY, NY) (the “Activities”), including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.

I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity.

I acknowledge and fully understand that I will be engaging in activities that are physical in nature and that there are risks associated with these activities including, but not limited to, serious injury and disability. I knowingly and voluntarily assume all such risks, even if arising from the negligence of Ballet Tech or others, and I assume full responsibility and liability for my participation.

I acknowledge that this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement will be used by Ballet Tech Foundation Inc., and that it will govern my actions and responsibilities at said activity.

I, on behalf of myself, my heirs, executors, administrators and assigns, hereby

WAIVE, RELEASE, AND DISCHARGE Ballet Tech Foundation Inc., and all of its past and present administrators, directors, officers, employees, and students (collectively the “Releasees”) from any and all claims, demands, losses, damages, or liabilities, including but not limited to, liability arising from the negligence or fault of the entities or persons released, that I may have or sustain with respect to any and all damage and/or injury, of any type (including but not limited to my death, disability, personal injury, property damage, property theft, or actions or harm of any kind), arising out of my use of Ballet Tech Foundation Inc’s facilities (the “Facilities”) or my participation in the Activities; and

PROMISE NOT TO SUE, AND PROMISE TO INDEMNIFY AND HOLD HARMLESS the Releasees from any and all claims, demands, losses, damages and liabilities for indemnities, contribution or otherwise with respect to any damage and/or injury, of any type, arising from my use of the Facilities or participation in the Activities. I further understand and agree that this provision applies to any and all liabilities or claims made as a result of participation in the Activities or use of the Facilities, whether caused by the negligence of a Releasee or otherwise, and I acknowledge that the Releasees are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.

I further understand and agree that this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law, and that if any portion of this Agreement is held invalid, the balance shall, notwithstanding, continue in full legal force and effect.
Agree:*

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.
Agree:*

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT ON BEHALF OF MY CHILD.
Date*

MonthDayYear
Date
Signature of Participant*

Clear
Signature of Parent/Guardian*

Clear
Should be Empty:

Ballet Tech Alumni Classes

Liability Waiver