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RELEASE AND AUTHORIZATION
I understand that risk of injury is inherent in any physical activity and I, on behalf of myself knowingly and voluntarily accept that risk. I, the undersigned, for myself, my heirs, administrators, and executors, hereby waive and release Kara Cookinham individually and KB's Center of Dance and Movement and its staff from any and all claims or damages/illnesses of any kind arising out of my participation in the exercise and/or dance program of KB's Center of Dance and Movement I further certify that the aforementioned student is in proper physical condition to participate in the exercise/dance program and that he/she has been examined by a licensed physician and found to be in proper physical condition to participate in said program. I, the undersigned, do hereby authorize Kara Cookinham or her designated agents (being teachers or administrators employed by KB's Center of Dance and Movement) to obtain medical treatment for me in emergency situations. I understand that I am responsible for any medical expenses and that the absence of health insurance does not make KB's Center of Dance and Movement responsible for payment of medical expenses. This authority includes the power to authorize any and all treatment deemed necessary under the circumstances by a licensed physician. This power is in essence a power of attorney and shall remain in effect for one year from the date of first class.

PHOTO RELEASE
I, grant KB’s Center of Dance and Movement its representatives and employees to take photographs of me and my property in connection with their facilities and operations. In addition, I authorize KB’s Center of Dance and Movement, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that KB’s Center of Dance and Movement may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content.

DAMAGE CLAUSE
Any damage to KB’s Center of Dance and Movement (ie. floors, barres, walls, props, mats, photos, stereo, t.v. etc.) that has been initiated by a student, will be the responsibility of the student/students guardian to fully reimburse KBCDM for that damage.

RELEASE AND AUTHORIZATION
I understand that risk of injury is inherent in any physical activity and I, on behalf of myself knowingly and voluntarily accept that risk. I, the undersigned, for myself, my heirs, administrators, and executors, hereby waive and release Kara Cookinham individually and KB's Center of Dance and Movement and its staff from any and all claims or damages/illnesses of any kind arising out of my participation in the exercise and/or dance program of KB's Center of Dance and Movement I further certify that the aforementioned student is in proper physical condition to participate in the exercise/dance program and that he/she has been examined by a licensed physician and found to be in proper physical condition to participate in said program. I, the undersigned, do hereby authorize Kara Cookinham or her designated agents (being teachers or administrators employed by KB's Center of Dance and Movement) to obtain medical treatment for me in emergency situations. I understand that I am responsible for any medical expenses and that the absence of health insurance does not make KB's Center of Dance and Movement responsible for payment of medical expenses. This authority includes the power to authorize any and all treatment deemed necessary under the circumstances by a licensed physician. This power is in essence a power of attorney and shall remain in effect for one year from the date of first class.

PHOTO RELEASE
I, grant KB’s Center of Dance and Movement its representatives and employees to take photographs of me and my property in connection with their facilities and operations. In addition, I authorize KB’s Center of Dance and Movement, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that KB’s Center of Dance and Movement may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content.

DAMAGE CLAUSE
Any damage to KB’s Center of Dance and Movement (ie. floors, barres, walls, props, mats, photos, stereo, t.v. etc.) that has been initiated by a student, will be the responsibility of the student/students guardian to fully reimburse KBCDM for that damage.