MEDICAL AND LIABILITY RELEASE:

I hereby release the Cache Valley Civic Ballet-Company and School (here after known as: CVCB), its officers, and employees from any liability of expense (including attorney’s fees) with the respect to claims for injuries, damages, and expenses sustained by above enrolled student resulting from participation in classes. Damages are limited to tuition cost for current semester.

NON-DISCRIMINATION POLICY STATEMENT:

As a recipient of Private, State, County and City financial assistance, the CVCB do not exclude, deny benefits to, or otherwise discriminate against any person on the grounds of race, color, national origin, age, sex, religion, or disability in admission to, participation in, or receipt of the services and benefits of any of its programs and activities or in employment therein, whether carried out, by CVCB directly or through a contractor or any other entity with whom the CVCB arranges to carry out is programs and activities.

MEDIA AUTHORIZATION AND RELEASE:

This authorization and release allows the CVCB to release the following information about you to the public: your name, your image (photograph, video, films, etc.), your story, and statements. B) If you don’t want the CVCB to disclose certain information, please put a check next to the information that you DON’T want disclosed.

Media Authorization and Release Understanding:

I can cancel this Authorization and Release at any time and for any reason by writing CVCB Administration at president@cvcballet.org. If I do that, my information cannot be disclosed after I cancel. Otherwise, this authorization and release will continue in effect as long as the CVCB is in operation.

Refusing or changing my mind about this Authorization and Release will not negatively affect me or my family in terms of our relationship with the CVCB.

I understand that others will see the information that I authorize to share publicly.

I understand what information may be released under this Authorization and Release.