1. I understand, on behalf of____________________, a minor, due hereby request enrollment in the dance,
acrobatics/gymnastics and related activities classes conducted by the David Blight School of Dance. In
consideration thereof I, for the minor and myself, our executors and assigns and other representatives due
hereby release and hold harmless the David Blight School of Dance and its owner from all claims, causes of
actions or suits which may result in the enrollment in these classes or any of the schools related functions,
except for gross negligence on the part of The David Blight School of Dance.
2. Medical Attention: In the event of illness or injury, or if deemed necessary by The David Blight School of
Dance, I hereby give my consent to The David Blight School of Dance staff, volunteer or paid, to provide
through a medical staff of its choice, customary medical/athletic training attention, temporary first aid,
transportation, and emergency medical services as warranted in the course of the minor participation.
3. I am aware that dance, acrobatics/gymnastics and related activities training places unusual stress on the
body and carries with it the risk of physical injury. Students may suffer injuries, possibly minor, serious or
catastrophic in nature.
4. I will make my child aware of the possibility of injury and encourage my child to follow all the safety rules and
coaches instructions. I understand that it is the parents’ responsibility to warn the child about the danger of
dance, acrobatics/gymnastics and related activities in language that the child understands. The David Blight
School of Dance will only warn the child through “safety messages” and our teaching style and progressions.
5. I affirm that I now have and will continue to provide proper hospitalization, health, and accident insurance
coverage which I consider adequate for both my child’s protection and my own protection.
6. I understand that good dance, acrobatics/gymnastics and related activities training involves touching and
adjustment of the students body by the instructor to help the student feel proper placement of the nec, torso,
amrs, hands, legs and feet and to assist in safe execution of learning of skills.
For any student who is not 18 years old. As legal parent guardian of this student I hereby verify by my signature
below that I full understand and accept each of the above conditions for permitting my child to participate in classes,
events, competitions, and activities conducted by The David Blight School of Dance.