Participation Wavier and Release

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Full Name ^*

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Date of birth ^*

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Email ^*

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Telephone Number ^*

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Emergency Contact Name ^*

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Emergency Contact Phone Number ^*

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I am aware of the risks of participating in dance, including group/private lessons or workshops. I promise not to hold The Pick School of Ballroom Dancing liable or pursue legal action against them. This waiver absolves The Pick School of Ballroom Dancing, its principals, owners, employees, volunteers, dance teachers, and premises lessors, as well as all of their heirs and assigns (collectively the “Releasees”), of any liability for injuries of any sort sustained on the premises before, during, or after any dance activities or group/private lessons or workshops at The Pick School. By signing this agreement, I agree to hold The Pick School of Ballroom Dancing and all of the Releasees completely harmless, including financial responsibility for any injuries sustained, regardless of the cause or circumstances. “A general release does not extend to claims that the creditor or releasing party does not know or suspect to exist in his or her favor at the time of executing the release and that, if known by him or her, would have materially affected his or her settlement with the debtor or released party.” I hereby agree that this release shall apply to all unknown, unforeseen, unanticipated and latent injuries, damages or losses resulting from participating in dance activities, including group/private lessons or workshops, as well as those damages that are now known, foreseen, anticipated and patent, and expressly assumes full responsibility for any injuries, damages or losses that have been or may be incurred as the result of participating in dance activities, including group/private lessons or workshops. ^*

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Todays Date ^*

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