# Fancy Feet Dance
## Assumption of Risk, Waiver of Liability & Media Release
**Participant Information**
Participant Name: __________________________________________
Date of Birth: ___________________
Parent/Legal Guardian (if participant is under 18): __________________________________________
Phone: ___________________ Email: _______________________________
Emergency Contact: ___________________________ Phone: ___________________
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## Assumption of Risk
I understand that participation in dance classes, camps, workshops, performances, parties, competitions, rehearsals, special events, and other activities offered by Fancy Feet Dance involves inherent risks, including but not limited to falls, collisions, strains, sprains, fractures, illness, and other injuries.
I voluntarily choose to participate (or allow my child to participate) in these activities and knowingly assume all risks associated with participation.
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## Medical Authorization
I certify that I (or my child) am physically able to participate in dance activities. I understand that it is my responsibility to consult a physician if I have concerns regarding participation.
In the event of an emergency, I authorize Fancy Feet Dance staff to obtain emergency medical treatment for myself or my child if I cannot be reached. I understand that I am responsible for all medical expenses incurred.
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## Release of Liability
To the fullest extent permitted by law, I, on behalf of myself, my child, my heirs, and personal representatives, release and hold harmless Fancy Feet Dance, its owners, directors, instructors, staff members, assistants, volunteers, contractors, and facility owners from any and all claims, demands, liabilities, damages, costs, or expenses arising from participation in any Fancy Feet Dance activity, except where caused by gross negligence or willful misconduct.
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## Illness & Communicable Diseases
I acknowledge that participation in group activities may expose participants to communicable illnesses. I agree not to attend classes or events if I or my child is experiencing symptoms of illness or has been advised to isolate due to a contagious condition.
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## Photo & Video Release
I grant Fancy Feet Dance permission to photograph, video record, or otherwise capture images of myself or my child during classes, camps, performances, competitions, and events. I understand these images may be used without compensation for promotional purposes, including:
* Website
* Social media
* Advertising
* Printed marketing materials
* Newsletters
* Studio displays
I understand that no identifying personal information beyond a first name may be used without additional permission.
☐ I DO NOT grant permission for photos or videos to be used for promotional purposes.
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## Personal Property
Fancy Feet Dance is not responsible for lost, stolen, or damaged personal property brought onto studio premises or to off-site events.
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## Parent/Guardian Responsibilities
Parents and guardians agree to:
* Ensure participants arrive on time and are picked up promptly.
* Notify the studio of any medical conditions, allergies, or emergency contact changes.
* Follow all studio policies and safety procedures.
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## Acknowledgment
I have carefully read this Assumption of Risk, Waiver of Liability, and Media Release. I understand its contents and voluntarily agree to its terms.
Participant Signature (18 or older):
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Date: _______________________
Parent/Guardian Signature (required if participant is under 18):
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Printed Name: _______________________________
Date: _______________________
