Indianola Dance Academy
Dancer Release Statement
READ BEFORE SIGNING
In consideration of _______________________________________, my child(ren)/ward(s) being allowed to participate in the sport of twirling, tumbling, dance, acrobatics and/or specialized sports training, related events and activities, I as the parent or guardian knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releases or others, and assume full responsibility for my child's participation.
PART 1: Release to allow Indianola Dance Academy, INC. (IDA) to render First Aid and/or seek Emergency Services in the absence of Parents or Guardians.
I fully understand that IDA staff members are not physicians or medical practitioners of any kind. With the above in mind, I hereby release the IDA staff to render temporary first aid to my child or children in the event of any injury or illness, and if deemed necessary by the IDA staff to seek medical help, including calling 911 for said child. ______(initials)
PART 2: Agreement not to sue or cause litigation versus Indianola Dance Academy, INC., its agents or employees.
We, the staff of IDA, recognize our obligation to make our students and their parents aware of the risks and hazards associated with the sport of twirling, tumbling, dance, acrobatics and/or specialized sports training. Students may suffer injuries, possibly dangerous and can lead to injury or death.
Parents should make their children aware of the possibility of injury and encourage their children to follow all the safety rules and the coaches’ instructions. ______(initials)
Indianola Dance Academy, INC., its coaches, teachers and other staff members, will not accept responsibility for injuries sustained by any student during the course of open workouts or in the course of any performance, clinic or competition in which he or she may participate or while traveling to or from the event.
With the above in mind, and being fully aware of the risks and possibility of injury involved, I consent to have my child or children participate in the programs offered by IDA and or its representatives whether paid or volunteer. ______(initials)
I also affirm that I now have and will continue to prove proper insurance coverage which I consider adequate for both my child's and my own protection. ______(initials)
I also understand that it is the parent's responsibility to warn the child about the dangers of injury. The parent should warn the child according to what the parent feels is appropriate. IDA will only warn the child through safety messages that align with our teaching style and progressions. ______(initials)
PART 3: I have read the policies, fees and payment plans. I agree to follow the rules as stated in the policies of the Indianola Dance Academy, INC. If I fail to follow the rules as stated, I know that my child may be dropped from classes. I agree to make the payments required for my child(ren) to participate in the classes he/she/they are registered and all other fees and merchandise involved. I also agree to pay any late fees outlined in these policies, legal fees, mediation or court costs if the Indianola Dance Academy has to pursue payment of my account.
I HAVE READ THE RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT AND THE POLICIES, FEES AND PAYMENT PLANS, FULLY UNDERSTAND THE TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT INDUCEMENT.