Fill and Sign the School Waiver Form

The Dance Workshop Application and Waiver FormName of Student ____________________________________________________________ Address of Student__________________________________________________________ Phone Number (work) ________________. Phone Number (home) ___________________. Date of Birth ________________________ Workshop Session _________________________________________________________ Tuition $______________ (Payable Prior to Workshop Session) Please read carefully and be aware that, in signing up and participating in the above program, you will be waiving and releasing all claims for injuries, arising out of this program, that you or the above participant might sustain. I do hereby fully release and discharge ___________________________ (Name of Instructor) and __________________________ (Name of Venue Provider) , hereinafter jointly called Releasees , from any and all claims from injuries, damage or loss which I (or any of my dependents under 18 years of age enrolled in this Workshop) may have or which may accrue to me (or dependents) on account of my (or their) participation in the above Dance Workshop sponsored activities. I further agree to indemnify and hold harmless Releasees from any claims resulting from injuries, damages and/or losses sustained by me or said dependent(s) arising out of, connected with, or in any way associated with Workshop activities. I understand and agree that there will be no refunds or credits made for absences or withdrawal from class and that students may only make up missed classes in any appropriate existing class during the same session day. Witness my signature as of the ______ day of __________________, 20_____. ____________________________________ Student or Parent/Guardian