I, the undersigned, hereby expressly and affirmatively state that I wish to participate in individualized/group/personal physical training, exercise, or dance instruction to be conducted by Chattanooga Ballet, Inc., its officers, agents, employees, instructors, subsidiaries, parent corporations, and all affiliated entities (hereinafter collectively referred to as "Chattanooga Ballet"). I realize that this activity involves risk of personal injury, serious disabling injuries, damage to property and, in extreme situations, the possibility of death. I also recognize that it is not possible for Chattanooga Ballet to specifically list each and every individual injury risk. However, knowing the material risks and appreciating, knowing and reasonable anticipating that injuries, disabilities and even death are a possibility in any individualized/group/personal physical training, exercise, or dance instruction, hereby expressly assume all risks, known or unknown, all possible risk of injury, disability and even death, which could occur by reason of my participation in any program or class conducted by Facility or otherwise inherent in individualized/group/personal physical training, exercise, or dance instruction.


I have had an opportunity to ask questions about Chattanooga Ballet's programs and classes and have consulted my physician individualized/group/personal physical training, exercise, or dance instruction program with Chattanooga Ballet. Any questions which I have asked have been answered to my satisfaction. I subjectively understand the risks involved in my participation in this activity and knowing and appreciating these risks I voluntarily choose to participate, assuming all the risks of injury, disability or even death due to my participation. I further understand that Chattanooga Ballet has made no representations, warranties or promises about the results I will obtain as a result of participating in any of Chattanooga Ballet's programs or classes, and has clearly explained to me that there can be no guarantee that I will reach my stated goals or achieve the results I desire by participating in any of their programs or classes.


The undersigned irrevocably and unconditionally, knowingly and voluntarily agrees to RELEASE AND FOREVER DISCHARGE Chattanooga Ballet, Inc., its officers, agents, employees, instructors, subsidiaries, parent corporations, and all affiliated entities from any and all causes of action, including any and all claims of negligence arising as a result of such activity from which liability could accrue to Chattanooga Ballet.


I am aware that this is a release of liability, and an acknowledgement of my voluntary and knowing assumption of the risk of injury. I have signed this document voluntarily and of my own free will in exchange for the privilege of participation.


If I am a minor, my parent and/or legal guardian has signed this document releasing Chattanooga Ballet from any and all such liability described above, and has acknowledged that I am knowingly and voluntarily assuming all risks of injury inherent to this activity.

I hereby grant and authorize Chattanooga Ballet, and individuals as appointed under the direction of the Chattanooga Ballet, the right to take, edit, alter, copy, exhibit, publish, distribute, and make use of any and all pictures or video taken of me to be used in and/or for legally promotional materials including, but not limited to, newsletters, flyers, posters, brochures, advertisements, fundraising letters, annual reports, press kits, and submissions to journalists, websites, social networking sites, and other print and digital communications, without payment or any other consideration. This authorization extends to all languages, media, formats, and markets now known or hereafter devised. This authorization shall continue indefinitely, unless I otherwise revoke said authorization in writing.

I understand and agree that these materials shall become the property of Chattanooga Ballet and will not be returned.

I hereby hold harmless, and release Chattanooga Ballet from all liability, petitions, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons may make while acting on my behalf or on behalf of my estate.

If the person signing is under the age of consent (18 years old as of date of signed release), then this release must be signed by a parent or guardian.