Liability Release Form And Assumption Of Risk Form-Dance Studio printable pdf download

Just For Kicks Dance Studio

Liability Release Form and Assumption of Risk

I/we realize that participation in dance classes and activities could result in some possible personal injury.

Despite precautions being taken by the studio, accidents and injuries may occur. By signing this release

form, I/we (the dancer and parent/guardian) assume all risks related to the use of any and all spaces

used by Just for Kicks Dance Studio.

I/we agree to release from responsibility the Just for Kicks Dance Studio, Salmon Arm and Revelstoke BC

including all teachers, dancers, staff members, and facilities used by both entities from any cause of

action, claims, or demands now and in the future. I/we will not hold Just for Kicks Dance Studio, Salmon

Arm Revelstoke BC, liable for any personal injury including: scrapes, bruises, cuts, sprains, fractures, broken

bones, concussions or death or any personal property damage/loss, which may occur on the premises

before, during or after classes.

Initial __________________ Date_____________________

Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our

behavior in addition to any damage I/we may cause to the facilities utilized by Just for Kicks Dance

Studio, Salmon Arm, BC

Initial_________________ Date_______________________

I understand that Just for Kicks Dance Studio, Salmon Arm, BC are licensed, accredited and insured

organizations. In the event that I/we should observe any unsafe conduct or conditions before, during or

after my/our classes, I/we agree to report the unsafe conduct or conditions to Patty Fleming, owner, the

administrator, instructors or staff members as soon as possible.

PHOTOGRPAHY/ VIDEO – I give permission for my son/daughter’s photographs/videos to be used for

publicity and advertising in the studio, on the Just for Kicks website, and in the community.

Sign_____________________

Date___________________

Dancer’s Name: _____________________________________________

Age: _______________________________________

(Print)

Dancer’s Signature: __________________________________________

Date: ______________________________________

(If over 18)

Parent/Guardian Name:______________________________________

Phone:_____________________________________

(Print)

Parent/Guardian Signature: __________________________________

Date: ______________________________________

(Please read and return to the Just for Kicks Dance Studio at registration or before your first dance class)

Liability Release Form And Assumption Of Risk Form-Dance Studio