• LIABILITY WAIVER AND RELEASE FORM 2026/2027

  • Nicholl Irish Dancers LLC
    842 Durham Rd, Newtown PA, 18940
    (267) 742-1045
    info@nichollirishdancers.com
  • Participant Information

  • Date of Birth:
     - -
  • LIABILITY WAIVER AND RELEASE

  • I, the undersigned participant or legal guardian of the participant, hereby acknowledge and agree to the following:
  • 1. Assumption of Risk & Voluntary Participation
    I understand that participating in Irish Dance classes/lessons, performances, parades, and other events ("Activities") with Nicholl Irish Dancers LLC involves risks, including but not limited to, physical injuries (e.g., falls, strains, sprains, broken bones), personal loss, and personal property damage. I voluntarily choose to participate and/or allow my child to participate in classes/lessons and all such Activities, accepting full responsibility for any risks involved.
  • 2. Release of Liability
    I release and hold harmless Nicholl Irish Dancers LLC, its owners, Instructors, contractors, and volunteers from any and all claims or liabilities for injuries, illness, death, damages, or losses arising from participation in any Activities or use of facilities, whether on or off the Nicholl Irish Dancers LLC premises, and whether caused by negligence or otherwise. This release includes all travel to and from Activities, whether via personal vehicle, chartered transportation, or otherwise.
  • 3. Medical Authorization
    I authorize Nicholl Irish Dancers LLC and its representatives to obtain emergency medical care and/or treatment as deemed necessary for myself or my child in the event of illness or injury. I understand I am financially responsible for any medical treatment and transportation costs incurred as a result of an injury or illness sustained during participation whether on or off Nicholl Irish Dancers LLC premises.
  • 4. Media Release

  • I grant permission for Nicholl Irish Dancers LLC to use photographs and/or videos of myself/my child for marketing, promotional, and social media purposes. I understand these materials may be used without compensation and remain the property of Nicholl Irish Dancers LLC.
  • 5. Code of Conduct

  • I agree to observe and obey the Policies & Procedures, Codes of Conduct, all posted rules and warnings, as well as verbal instructions or directions given by Nicholl Irish Dancers LLC, its Instructors, contractors, and volunteers. I understand that failure to do so may result in disciplinary actions including, but not limited to - my/my child's suspension from class participation or my/my child's total removal from Nicholl Irish Dancers LLC's dance program.
  • ACKNOWLEDGEMENT AND SIGNATURE

  • I hereby certify that I/my child are in good health and physically able to safely participate in Irish dance classes/lessons and all other Activities.
  • I have read, understand, and agree to the terms of this waiver and release, and sign voluntarily.
  • Date:
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  • Date:
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  • Should be Empty: