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Steppin' Time 2026-27 Student Waiver
5
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1
Parent Name
Parent First Name
Parent Last Name
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2
Emergency Contact Phone Number
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3
Student Name
Student First Name
Student Last Name
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4
Student Date of Birth
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Students my be 11 before 7/1 to participate.
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5
Liability Waiver
To whom it may concern, I give permission for the above student to participate in dance instruction classes. I, the undersigned, do hereby release, forever discharge and agree to hold harmless LIFE BIBLE CHURCH, UNITE HOMESCHOOL, INDIA WILLARD, and its pastors, directors, employees, volunteers and teachers of Steppin’Time Dance Club from any and all liability, claims or demands for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the partner dance and line dance lessons and social events. Furthermore, I, on behalf of my minor Participant, hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreation and activities involved therein.
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