Diversity Dance Studio, LLC
Liability of Release
Child’s Name_________________________________________ Child’s Age________________________ Any Allergies?________________ If yes, please list ___________________________________________ Parent’s Names (Please list ALL guardians)___________________________________________________ Parents Phone # (Please list two contact #’s)_________________________________________________ Parents Email__________________________________________________________________________
Please list any other information you would like us to know about your child: _____________________________________________________________________________________ _____________________________________________________________________________________
Diversity Dance Studio Photo/Video Release:
We are constantly photographing/filming children to share with the public all the wonderful activities and events we do within the community. We may use these photos/videos in publications such as our website, Instagram, Facebook, local newspapers, flyers and other publications which are not limited to those listed above. Please Initial and sign below:
______ I give permission to use my child’s photo in any Diversity Dance Studio publication.
______ I do not give permission to use my child’s photo in any Diversity Dance Studio publication
Parent/Guardian Name:________________________________________________________________
Parent/Guardian Signature: _____________________________________________________________
Date: ____________
*Please note if you attend an event where filming or photos are being taken, we cannot guarantee your child will not be photographed or filmed in a group show. To guarantee this we advise that you do not participate in the event or make sure you keep an eye on your child.
Diversity Dance Studio Liability Release:
I acknowledge, understand and agree to release Diversity Dance Studio, LLC from liability and to indemnify and hold harmless Diversity Dance Studio, LLC, and any of its employees. This release is for all liability for personal injuries inside and outside of the classroom, lobby or studio (including death), property loss or damage occasioned by, or in connection with any activity or accommodations for this and all future events. The undersigned further agrees to abide by all the rules and regulations promulgated by the owner of the event and/or its affiliate groups and vendors throughout the event.
Parent/Guardian Name: ________________________________________________________________
Parent/Guardian Signature:_____________________________________________________________
Date: ____________
I agree that by accepting these terms and conditions, it counts as my digital signature and release.
Photograph / Video Consent to Commercial / Social Media
Use and Release Form
STATEMENT REGARDING THE TAKING AND USE OF AUDIO, VIDEO, AND PHOTOGRAPHY: At Diversity Dance Studio, we are proud of our studio, our staff, and our dance family and want the world to see why! In today’s age of social media, an online presence is essential to sharing our excitement for what we create together. While in studio or representing Diversity Dance Studio at competitions or conventions, you and/or your child may be photographed or recorded on video. Diversity Dance Studio may use these images, videos, and/or audio recordings in publicity and/or promotion for Diversity Dance Studio. Our goal is to put our best foot forward and to reflect well on our studio, staff, and students, but we cannot always guarantee that everyone will love their photo or video. Diversity Dance Studio retains sole discretion over any use or public display of such images or recordings but we are always open to hear any concerns and may, but are not required to, modify, delete, or otherwise cease use of photo, audio, or video where we deem appropriate.
CONSENT and RELEASE:
For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged,
I , on behalf of myself and my minor child (where applicable), hereby give Diversity Dance, LLC (d/b/a Diversity Dance Studio), together with its principal(s), employees, agents, and volunteers, when acting on behalf of Diversity Dance Studio, the absolute and irrevocable right and permission, with respect to the photographs, audio, video and/or film that may have been taken previously, or will be taken or recorded while on studio premises, off-site at studio events or functions, or at convention or competition events as a student of Diversity Dance Studio to:
copyright such photographs, images, or audio/video recordings in its own name;
use, re-use, publish and re-publish the same in whole or in part, individually or in conjunction with other photographs, images, or audio/video recordings in any medium, for purposes of illustration, promotion, or advertising of Diversity Dance Studio; and
use my name in connection therewith if it so chooses.
In addition to the foregoing consent, on behalf of myself and my minor child (where applicable), I hereby release Diversity Dance Studio and its principal(s), employees, volunteers, and agents, along with their respective heirs, executors, assigns, and any designee(s) (the “Releasees”) from any and all claims, causes of action, and/or demands for compensation for damages, foreseen or unforeseen, whether arising now or any time in the future, associated with the artistic, and/or promotional use of photographs, audio, or video unless it can be shown that said reproduction was maliciously produced and published for the sole purpose of subjecting the person or persons depicted to conspicuous ridicule, scandal, reproach, scorn, or indignity.
I, the undersigned, certify that I am of legal age, that I have read the foregoing Consent to Commercial / Social Media Use and Release Form, that I fully understand the contents hereof, and have entered into this agreement of my own free will.
Student’s Name:
Signature (of Student, if 18 or over or Parent/Guardian, if subject is a minor).
____________________________
Printed Name of Signatory
____________________________
Date
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