Canvas Dance LLC (Canvas Dance Arts)
Liability Waiver Form



I realize that participation in dance classes and activities could involve some possible personal injury. Despite precautions, accidents and injuries may occur. By signing this release form, I (the dancer’s parent/guardian) assume all risks related to the use of any and all spaces used by Canvas Dance LLC/Canvas Dance Arts.

I agree to release and hold harmless Canvas Dance LLC/Canvas Dance Arts including its teachers, dancers, staff members, and facilities used by both entities from any cause of action, claims, or demands now and in the future. I/we will not hold Canvas Dance LLC/Canvas Dance Arts liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes. Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by Canvas Dance LLC/Canvas Dance Arts.

AUTHORIZATION FOR FILMING/PHOTOGRAPHY
I hereby authorize Canvas Dance Arts (Canvas Dance LLC), its legal representatives, agents,
and employees to: (a) photograph, film and record (the above named individual) for the
marketing and public relations purposes; and (b) release the individual’s name, image and
other identifiable information to the public for marketing and public relations purposes. I
understand that the images/recordings may include his/her face, body and/or voice.
I understand that the Agency has not received any money paid for work or a service in connection
with the images/recordings and is permitting the photography/recording solely upon my
authorization.
This authorization shall expire in 20 years. I understand that I may revoke this authorization at
any time in writing, except to the extent that the Agency and its staff have taken action in
reliance on this authorization. I understand that, once the images/recordings are made, they
are subject to redisclosure and will not be subject to any privacy protection.
I hereby irrevocably release, waive and forever discharge any and all claims, causes of action,
demands, damages, rights, remedies, liabilities and obligations of whatever kind or character
that I or the above named individual may have had, may now have, or may later assert (at law,
in equity or otherwise) against the Agency arising pursuant to, in connection with or related in
any way to: (a) the images/recordings; or (b) the use or disclosure of the images/recordings or
any portion or aspect thereof; and/or (c) the failure to complete the images/recordings due to
circumstances dictating that the filming or recording be terminated.