As parent/legal guardian, I give my consent for my dancer   Dancer's First Name*   Last Name*   to participate in the dance/physical fitness program that has been designed for me by Georgia Metropolitan Dance Theatre (GMDT). In consideration of being allowed to use personal equipment, commercial equipment, commercial facility, or machinery to achieve set dance and fitness goals, I do hereby waive, release, and forever discharge said company, or organization and the officers, agents, employees, representatives, instructors, subcontractors, volunteers, or executors, and all others from any and all responsibilities or liability from injuries or damage resulting from my participation in any activity or use of equipment or machinery as mentioned above.    

I recognize that dance and physical fitness activities and exercise carries some risk to the musculoskeletal system (sprains, strains) and the cardio respiratory system (dizziness, discomfort in breathing, heart attack). I hereby certify that I know of no medical problem (except those noted on previous page) that would increase my dancer's risk of illness and injury as a result of their participation in a designed dance and fitness program. My dancer   Dancer's First Name*   Last Name*   is voluntarily participating in dance and fitness (strength training, flexibility training, aerobic exercise, Pilates exercises, and yoga) and exercise activities and using equipment and machinery with knowledge of the dangers involved. I hereby agree to expressly assume and accept any and all risks of injury or death. I do also hereby release all those mentioned above and any others acting upon their behalf from any responsibility or liability for any injury or damage to my dancer(s), including those caused by the negligent act or omission of any of those mentioned or others acting on their behalf or in any way arising out of or connected with my dancer's participation in any activities of my dance or fitness instructors associated with GMDT, or those activities performed at a training facility using personal, or any commercial equipment.   

I do hereby further my dancer Dancer's First Name*   Last Name*   to be physically sound and suffering from no condition, impairment, disease, infirmity, or other illness not otherwise stated that would prevent their participation in a designed dance/fitness program or use of equipment or machinery to attain their personal dance and fitness goals. I acknowledge that they have decided to participate in fitness and exercise activities and use fitness equipment or machinery with or without the expressed approval of their physician and do hereby assume all responsibility for their participation, activities, and utilization of equipment and machinery in their activities.            

I hereby give Georgia Metropolitan Dance Theatre permission to administer basic first aid and/or CPR to my dancer,    Dancer's First Name*   Last Name*        and/or take my dancer   Dancer's First Name*   Last Name*   to a hospital and to secure medical treatment when I cannot be reached or when delay would be dangerous to my child’s health.