Waiver of Liability, Assumption of Risk & Media Release

For Dance Classes, Camps, Events, Parties, Workshops & Studio Activities

Participant Name: ______________________________________

Date of Birth: ____________________ Age: __________

Parent/Guardian Name (if participant is under 18): ______________________________________

Phone: ______________________

Email: ______________________________________

Acknowledgment of Risk

I understand that participation in dance classes, camps, birthday parties, workshops, performances, rehearsals, special events, open gyms, field trips, and all activities hosted by Fancy Feet Dance Academy involves inherent risks. These risks include, but are not limited to:

Slips, trips, and falls
Muscle strains or sprains
Broken bones
Head injuries
Physical contact with other participants
Injuries resulting from dance equipment or studio facilities
Illness or exposure to communicable diseases

I voluntarily choose to participate and assume all risks associated with participation.

Release of Liability

In consideration for being allowed to participate in activities at Fancy Feet Dance Academy, I, on behalf of myself and/or my child, hereby release, waive, discharge, and hold harmless:

Fancy Feet Dance Academy
Its owners
Directors
Employees
Independent contractors
Instructors
Volunteers
Agents
Representatives
Landlords and property owners

from any and all liability, claims, demands, actions, damages, costs, expenses, or causes of action arising out of or related to participation in any Fancy Feet Dance Academy program, whether caused by negligence or otherwise, to the fullest extent permitted by California law.

Medical Authorization

In the event of an emergency, I authorize Fancy Feet Dance Academy staff to obtain emergency medical treatment for myself or my child if I cannot be reached immediately.

I understand that I am solely responsible for any medical expenses incurred.

Emergency Contact

Name: ______________________________________

Relationship: ________________________________

Phone: ______________________________________

Health Statement

I certify that I (or my child):

Am physically able to participate in dance and physical activities.
Have disclosed any medical conditions, allergies, injuries, or limitations that may affect participation.
Will not attend classes or events if experiencing symptoms of a contagious illness.

Medical information or allergies:

Personal Property

Fancy Feet Dance Academy is not responsible for lost, stolen, or damaged personal belongings brought onto studio property or to off-site events.

Behavior Policy

Participants and parents are expected to behave respectfully toward staff, instructors, volunteers, and other families.

Fancy Feet Dance Academy reserves the right to remove any participant from a class, camp, party, or event for unsafe or disruptive behavior without refund.

Photography & Video Release

I grant permission to Fancy Feet Dance Academy to photograph and/or record myself or my child during classes, camps, parties, performances, events, and other activities.

I authorize Fancy Feet Dance Academy to use these photographs and videos for promotional purposes including:

Website
Social media
Advertising
Marketing materials
Print publications
Studio displays

No compensation will be provided for such use.

☐ I do NOT give permission for photos or videos to be used for promotional purposes.

Parent/Guardian Responsibility

I understand that:

I am responsible for dropping off and picking up my child on time.
Fancy Feet Dance Academy is not responsible for supervising children before or after scheduled activities unless specifically stated.
During birthday parties and special events, parents remain responsible for supervising non-participating siblings.
Governing Law

This agreement shall be governed by and interpreted under the laws of the State of California.

If any provision of this agreement is determined to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

Acknowledgment & Signature

By signing below, I acknowledge that I have carefully read this Waiver of Liability, Assumption of Risk, and Media Release. I understand its contents, understand that I am giving up certain legal rights, and voluntarily agree to its terms.

Participant Name: ______________________________________

Participant Signature (18+):

______________________________________ Date: _______________

Parent/Guardian Signature (Required for participants under 18):

______________________________________ Date: _______________

Printed Name: ______________________________________