FANCY FEET DANCE ACADEMY
PARENT & ME CLASS LIABILITY WAIVER & RELEASE

Participant/Child Name: ___________________________________________

Child’s Date of Birth: _____________________________________________

Parent/Guardian Name: ____________________________________________

Phone: ___________________________ Email: ___________________________

ASSUMPTION OF RISK

I understand that participation in dance, movement, music, crafts, games, and other activities offered by Fancy Feet Dance Academy (“Fancy Feet”) involves inherent risks. These risks may include, but are not limited to, falls, slips, collisions, muscle strains, sprains, injuries, allergic reactions, or other physical injury.

I understand that young children may participate at different developmental levels and that activities may involve physical movement, dancing, stretching, walking, jumping, and interaction with other participants and instructors.

I voluntarily choose to have my child participate in the Parent & Me class and understand and accept the inherent risks associated with participation.

PARENT/GUARDIAN RESPONSIBILITY

I understand that a parent or legal guardian is required to remain with and supervise their child during the Parent & Me class unless otherwise instructed by Fancy Feet staff.

I agree to monitor my child and immediately notify the instructor or Fancy Feet staff if my child is experiencing pain, illness, injury, distress, or any other condition that may affect their ability to safely participate.

I certify that my child is physically able to participate in the activities for which they are registered. I will notify Fancy Feet of any physical limitations, allergies, medical conditions, or other circumstances that may affect my child's participation.

RELEASE AND WAIVER

To the fullest extent permitted by applicable law, I, on behalf of myself and my child, release and hold harmless Fancy Feet Dance Academy, its owners, instructors, employees, contractors, volunteers, and representatives from claims arising from the ordinary risks and hazards inherent in participation in the class.

This waiver does not release or waive any liability that cannot legally be waived under California law.

MEDICAL AUTHORIZATION

In the event of an emergency, I authorize Fancy Feet Dance Academy and its staff to seek reasonable emergency medical assistance for my child when I cannot be reached or when immediate action is reasonably necessary.

I understand that Fancy Feet will make reasonable efforts to contact me or the emergency contact listed below.

Emergency Contact: _______________________________________________

Emergency Phone: _________________________________________________

PHOTOGRAPHY & VIDEO

I understand that photographs and/or video may be taken during Fancy Feet activities.

Optional Media Permission:
☐ I give permission for my child to appear in photographs or video used by Fancy Feet Dance Academy for promotional, educational, website, and social media purposes.

☐ I do not give permission for my child to appear in promotional photographs or video.

ACKNOWLEDGMENT

I have carefully read this waiver and understand its contents. I understand that I am giving up certain legal rights to the extent permitted by law. I have had the opportunity to ask questions before signing.

I certify that I am the parent or legal guardian of the child named above and have authority to provide this consent.

Parent/Guardian Signature: _________________________________________

Printed Name: ____________________________________________________

Date: ___________________________

Fancy Feet Staff/Witness: _________________________________________

Date: ___________________________