WAIVER AND RELEASE OF LIABILITY, CONSENT TO EMERGENCY MEDICAL TREATMENT AND STUDIO POLICY AGREEMENT
Assumption of Risk
I, the undersigned parent or guardian of the below named minor child (the participant), who desires to participant in dance classes and performances offered and organized by Divine Dance Studio hereby acknowledge that I am aware that there are significant risks associated with participation in such dance classes and performances, including, without limitations, the risk of serious bodily injury. On behalf of myself, my spouse and participant, and our respective heirs, administrator, representatives and successors, I willingly assume such risks.
Waiver and Release
I, the undersigned parent or guardian of the participant, for myself my spouse and participant and our respective heirs, administrators, representatives and successors, hereby waive the right to bring any claim or suit and hereby voluntarily release and discharge Divine Dance Studio, its owner (Samantha Daniels), employees, independent contractors, agents and insurers from any and all claims, demands, causes of action, liabilities, damages, costs or expenses (referred to herein collectively as “Claims or Lossesâ€) arising out of, relating to or in any way connected with Participants participation in the studios dance classes and performances, including, without limitation, any claims or losses for personal injury, or property damage allegedly arising out of the negligent acts or omissions of Divine Dance Studios owners, employees, independent contractors or other agents.
Consent to Emergency Medical and Dental Treatment
I, the undersigned parent or guardian of the Participant, hereby authorize Divine Dance Studio and its owners, employees, independent contractors and other agents to consent and authorize the emergency medical treatment of the below named Participant by a physician duly licensed under the provisions of the Idaho Medical Practice Act. I understand that this consent to Emergency Medical Treatment will be used by The Studio only if it is unable to reach me within a reasonable period of time given the circumstances of the emergency. On behalf of myself, my spouse and Participant, I forever release Divine Dance Studio and its owners, employees, independent contractors and other agents from any and all liability related to the exercise of the authorization provided herein.
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Signature of Parent or Guardian Date
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Print Name of Parent or Guardian Phone Number