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Emerald City Dance Complex

Liability Release/Waiver Form  


All participants and students must complete this form before participating in any classes, rehearsals, workshops, performances, competitions, or affiliated events with Emerald City Dance Complex (“ECDC”). If a participant is under age 18, a parent or guardian must sign this form.

 

Admission to class and/or rehearsal will not be granted if this form is not received prior to class and is not properly signed.  


Waiver of Liability  

I recognize and understand the risks of physical injury inherent to dance and dance training and I fully assume those risks. I hereby release ECDC, its affiliate dance studios, event sponsors, employees and dance teachers from all liability for injuries sustained or illnesses contracted while attending or participating in any dance classes, rehearsals, workshops, performances, competitions or other affiliated events. I agree to indemnify, defend, and hold harmless ECDC, its affiliate dance studios, event sponsors, employees and dance teachers for liabilities, costs and judgments arising from acts of omissions committed by me or my child which result in injury or damage to any person or property.  


I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself, my  child(ren) or my family/household (including, but not limited to, personal injury, disability, and death), illness,  damage, loss, claim, liability, or expense, of any kind, that I, my child(ren) or my family/household may  experience or incur in connection with attendance at ECDC or participation in ECDC classes.  


Protection of Property  

I understand and agree that it is my sole responsibility to safeguard my personal property while attending or participating in any classes, rehearsals, workshops, performances, competitions, or other affiliated events. I hereby release ECDC, its affiliate dance studios, event sponsors, employees, and dance teachers from all liability for loss or damage to my personal property while attending or participating in classes, rehearsals, workshops, or performances. I also agree to abide by any rules, regulations and policies set forth by ECDC. 


Medical Attention  

In case of physical injury or medical emergency, I hereby authorize ECDC to make necessary arrangements to transport myself or my child to a medical treatment facility, as necessary. All such transportation and medical treatment will be at my sole cost and expense. In an extreme emergency, or if my child is under 18 years of age, I understand that ECDC will attempt to notify the person(s) I have named below as my emergency contact(s) of my condition and how to reach me.  


Media Release  

ECDC reserves the right to use photographs and videos taken during classes, workshops, performances, competitions, or other affiliated events for the purposes of instruction, advertising and promoting ECDC and its programs. Students, or parents of students who are minors, who do not wish to comply with this policy must notify ECDC prior to participation in class.  


Acknowledgement of Waiver  

In signing this Release, I acknowledge and represent that I have fully informed myself of the content of the  waiver and hold harmless agreement by reading it before I sign it, and I understand that I sign this document as  my own free act and deed; no oral representations, statements, or inducements, apart from the written  statement, have been made. I further state that I am at least eighteen (18) years of age and am fully competent to sign this agreement; and that I execute this release for full, adequate, and complete consideration fully intending to be bound by the same. I further state that there are no health-related reasons or problems which preclude or restrict my or my child’s participation in this activity, and that I will pay any medical costs that may be attendant as a result of injury to me or my child.  

Printed Name of Participant (s) at Emerald City Dance Complex:

Parent/Guardian Information:

Multi-line address

Emergency Contact & Relationship to Participant  

Dancer Information:

Signature of Participant or Parent/Guardian (if under 18 yrs)

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Contact Us: Emerald City Dance Complex

Our Location:
5959 Corson Ave S, Suite E
Seattle, WA 98108
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