• Acknowledgement of Risk and Waiver of Liability & Photo Release Waiver Form

  • Format: (000) 000-0000.
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • I consent to email communication.*
  • Liability Waiver

     

    I hereby acknowledge that my participation in the dance classes and activities offered by Maven Movement (the “Dance Program”) could involve possible personal injury. By signing this release form I assume all risks is connection with participating in the Dance Program. I agree to release and hold harmless the Director (defined above), Maven Movement, and each of their teachers, instructors, staff members, and facilities (collectively the “Maven Movement Parties”) from any liability, cause of action, claims or demands now and in the future. I also hereby agree to not hold any of the Maven Movement Team liable for any injury, damages or losses in connection with my participation in the Dance Program. 

  • Please let us know if you have any light and/or sound sensitivities. *If yes, please communicate with your instructor.*
  • Photo/Video Release

    I hereby authorize Maven Movement (Ashley Brodeur) to utilize photographs, videos, and recordings (collectively the “Images”) of myself either captured by Maven Movement Parties or provided by me in any promotional material, including but not limited to social media websites and outlets, brochures, promotional videos and dance clips, and posters.

    I hereby release and discharge the Maven Movement Parties of and from any and all claims, demands, causes of action, liability, damages, and losses of any kind and nature that arise directly or indirectly from the use of my name and/or the Images. The Images are to be used exclusively by the Maven Movement Parties and may not be sold, licensed or otherwise transferred by the Maven Movement Parties.

    I fully understand and acknowledge that the Maven Movement Parties are relying on the statements above, and that my participation in the Dance Program are conditioned upon this Acknowledgment, Waiver and Release form.

    I HAVE READ AND UNDERSTAND THE ABOVE PHOTO RELEASE. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE. I ACCEPT:

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: