Wellness in Motion
Spring Hill, TN
Photography, Video & Liability Release Form
Participant Name:
Date of Birth (if under 18):
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Month
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Day
Year
Date
Parent / Guardian Name (if applicable):
Phone Number:
Format: (000) 000-0000.
Email Address:
example@example.com
Studio Name:
Photography & Video Release
I understand that during participation in Wellness in Motion dance classes and related activities, photographs and/or video recordings may be taken for promotional, educational, or informational purposes.
Permission for photography and video use.
YES - I grant permission for photography and video use.
NO - I do not grant permission for photography or video use.
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Assumption of Risk & Liability Waiver
I acknowledge that participation in dance, movement, and fitness activities
involves inherent physical risks,
including but not limited to muscle strain, injury, or physical exertion.
By signing this form, I voluntarily assume all risks associated with
participation and agree to release and hold harmless Wellness in Motion,
its instructors, contractors, and affiliates from any and all claims or
liabilities, except in cases of gross negligence.
I have read, understand, and agree to the terms outlined above.
Participant / Parent or Guardian Signature:
Printed Name:
Date:
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Month
-
Day
Year
Date
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