FANCY FEET DANCE
WAIVER, RELEASE OF LIABILITY, ASSUMPTION OF RISK & PARTICIPATION AGREEMENT

Fancy Feet Dance
712 57th Street, Sacramento, CA 95819
1331 Broadway, Sacramento, CA
Phone: 916-451-4900
Email: Info@fancyfeetdance.net

STUDENT INFORMATION

Student Name: ______________________________________________

Date of Birth: ______________________

Parent/Guardian Name: _______________________________________

Phone: ___________________________

Email: _____________________________________________________

1. PARTICIPATION IN DANCE ACTIVITIES

I understand that participation in dance classes, rehearsals, performances, camps, workshops, competitions, special events, field trips, and other activities provided by Fancy Feet Dance involves physical activity.

I understand that dance may involve stretching, jumping, turning, running, choreography, floor work, partnering, props, and other physical movements. Participation may involve risks including, but not limited to, falls, slips, collisions, strains, sprains, bruises, fractures, muscle injuries, head injuries, illness, and other physical injuries.

I voluntarily choose to allow myself and/or my child to participate in Fancy Feet Dance activities and understand that participation is not mandatory.

2. ASSUMPTION OF RISK

I knowingly and voluntarily assume the risks associated with participation in dance and related activities, including risks that may be known or reasonably foreseeable.

I understand that injuries may occur even when instructors and staff use reasonable safety precautions and provide appropriate instruction.

I agree that the student will immediately notify an instructor or Fancy Feet Dance staff member if they experience pain, dizziness, illness, injury, or otherwise feel unable to safely participate.

3. RELEASE OF LIABILITY

To the fullest extent permitted by California law, I, on behalf of myself and, where legally permitted, my participating minor child, agree to release and discharge Fancy Feet Dance, its owners, directors, instructors, employees, contractors, volunteers, agents, affiliates, and representatives from claims arising from participation in Fancy Feet Dance activities, except for claims that cannot legally be released under applicable law.

This release applies to activities occurring at Fancy Feet Dance locations as well as performances, rehearsals, camps, competitions, special events, and activities conducted at other venues.

4. MEDICAL RESPONSIBILITY

I certify that the student is physically able to participate in dance activities, or that I have consulted with an appropriate healthcare professional regarding participation.

I understand that Fancy Feet Dance does not provide medical care and that I am responsible for notifying Fancy Feet Dance of any physical limitations, allergies, injuries, medical restrictions, or other information that could affect the student's ability to safely participate.

5. EMERGENCY MEDICAL AUTHORIZATION

In the event of an emergency involving the student, I authorize Fancy Feet Dance staff to take reasonable steps to obtain emergency medical assistance for the student if I cannot be reached immediately.

I understand that Fancy Feet Dance will make reasonable efforts to contact the parent/guardian or emergency contact as soon as reasonably possible.

I understand that I am responsible for any medical, ambulance, hospital, physician, or other healthcare expenses incurred on behalf of the student.

Emergency Contact Name: _____________________________________

Relationship: ______________________

Phone: ____________________________

6. ILLNESS & COMMUNICABLE CONDITIONS

I agree not to bring the student to class, rehearsal, camp, or an event when the student is experiencing symptoms that would reasonably make participation unsafe for the student or others.

I agree to follow Fancy Feet Dance's current health and safety policies.

7. FACILITY, EQUIPMENT & PERSONAL PROPERTY

I understand that dance activities may involve the use of floors, mirrors, barres, mats, props, sound equipment, costumes, and other studio or event equipment.

I agree that the student will follow instructor directions and studio safety rules.

Fancy Feet Dance is not responsible for lost, stolen, or damaged personal belongings brought to the studio or an event, except as required by applicable law.

8. PARENT/GUARDIAN RESPONSIBILITY

If signing on behalf of a minor, I represent that I am the student's parent or legal guardian and have authority to enter into this agreement.

I agree to inform Fancy Feet Dance of any condition, restriction, injury, or other circumstance that may affect the student's ability to safely participate.

I understand that the student is expected to follow instructor directions and Fancy Feet Dance policies.

9. PHOTO & VIDEO RELEASE

I understand that Fancy Feet Dance may photograph or record students during classes, rehearsals, performances, camps, and studio events.

Please select one:

☐ YES, I give Fancy Feet Dance permission to photograph and/or record my child and use those images or recordings for studio promotional purposes, including social media, website, advertising, marketing materials, and studio communications.

☐ NO, I do not give permission for my child's photograph or video to be used for promotional purposes.

I understand that I may contact Fancy Feet Dance regarding the removal or restriction of future promotional use.

10. COMPLIANCE WITH STUDIO POLICIES

I agree that the student and parent/guardian will comply with Fancy Feet Dance rules, policies, instructor directions, attendance requirements, safety procedures, and other policies communicated by the studio.

I understand that Fancy Feet Dance may update its policies as reasonably necessary.

11. SEVERABILITY

If any provision of this agreement is determined to be invalid or unenforceable, the remaining provisions shall remain in effect to the fullest extent permitted by law.

12. ACKNOWLEDGMENT

I have carefully read this Waiver, Release of Liability, Assumption of Risk & Participation Agreement.

I understand that participation in dance involves inherent risks and that I am voluntarily agreeing to the terms of this agreement.

If signing on behalf of a minor, I confirm that I am the parent or legal guardian of the student and have authority to provide consent for the student's participation.

I understand that this agreement affects legal rights and have had the opportunity to ask questions and seek independent legal advice before signing.

STUDENT

Student Name: ______________________________________________

PARENT / LEGAL GUARDIAN

Parent/Guardian Name: _______________________________________

Signature: _________________________________________________

Date: ______________________

Phone: ____________________

Email: _____________________________________________________

SECOND PARENT / LEGAL GUARDIAN, IF APPLICABLE

Name: _____________________________________________________

Signature: _________________________________________________

Date: ______________________