I, Parent/Guardian name * First Name Last Name have chosen for my child/children Student name(s) * First Name Last Name to participate in instructions held at Reflections Dance Academy, LLC given by private instructors.I hereby release and hold harmless Mercedes Vamprine, Reflections Dance Academy LLC, its directors, employees, independent contractors, agents, successors and assigns from any and all claims, causes of action, suits or liability, costs and expenses (including, without limitation, reasonable attorneys' fees) arising out of, or in connection with, any loss, personal injury, death, or other damage that I may incur or suffer by reason or as a result of my enrollment or participation at Reflections Dance Academy LLC. Some of the specific risks include the placement of unusual stresses of the body, falls and tripping which may lead to accidents resulting in, but not limited to, mild or severe bodily injury. I understand on behalf of myself and my child/children to release, hold harmless and discharge Reflections Dance Academy LLC for all claims, costs, liabilities, expenses or judgments, including attorney’s fees and court costs for any occurrence in connection with any instruction during the COVID-19 outbreak. I/We understand that the Studio cannot be responsible for any injuries or damages experienced by my/our child during his/her participation in such activities.Medical Treatment:I authorize Reflections Dance Academy LLC to obtain medical treatment for me or my child in the event of an emergency. I agree to be financially responsible for any resulting medical expenses.Media:I understand that Reflections Dance Academy LLC may record my participation in competitions, performances, recitals, or classes on video or by photograph. I grant Reflections Dance Academy LLC unlimited use of any such recordings with no obligation to me. Such recordings are the sole property of Reflections Dance Academy LLC. I have read the rules and waiver in their entirety, understand them, and agree to comply with their contents. For those under 18, waiver must be signed by parent or guardian.
I/We have read and agree to follow all studio policies, waiver, and release all claims. Physical Activity Waiver and Photo Release form should be printed and signed if electronic signature not received.