Del Alma Liability Waiver and Release of Claims
This form must be completed before participating in any classes or programs offered at Del Alma
Dance Studio. Failure to complete this form will result in exclusion from classes, programs and
related services. We reserve the right to refuse service.
Participant Information:
Name:
Date:
Address:
Phone Number:
Email:
Program Name and Session:
Emergency Contact Information:
Duration
This waiver will remain in effect through the duration of the program. A photocopy of this
waiver will hold the same effect as an original.
Acknowledgement of Risks
I,
, acknowledge that participating in classes at Del Alma
Dance Studios, involves inherent risks, including but not limited to physical injury, falls or
accidents. I understand that these risks can occur during dance lessons, practice sessions or any
related activities (hereinafter collectively named “Classes”).
I, have been informed by Del Alma Dance Company, its owners, instructors, employees and
agents (hereinafter collectively named the “The Studio”) that to better mitigate these risks they
advise all participants to dress in appropriate athletic attire and shoes. I have been informed that
the use of apparel with excess hanging fabric which might cause an obstruction is highly
discouraged. I have been informed that the use of proper footwear is subject to my needs but
should be limited to dance shoes (including but not limited to Standard Ballroom Shoes, Jazz
Shoes and Standard Ballroom Heels). I have been informed that proper attire is essential in
mitigating my risk to injury.
Release of Liability
In consideration of being allowed to participate in dance classes and related activities I hereby
release, waive, discharge, and covenant not to sue the Studio for any and all claims including
negligence, that may arise from my participation in dance classes or related activities.
Indemnification
I agree to indemnify and hold harmless the studio from any claims demands losses or damages
including attorney’s fees arising from my participation in dance classes or related activities.
Medical Disclaimer
I certify that I am physically fit and able to engage in physical activity and that I have consulted
with the physician if necessary. I understand that it is my responsibility to inform the instructor
of any pre-existing conditions or limitations that might affect my participation in writing before
participating in any classes offered by the Studio.
Photography and video release
I grant permission to the studio to take photographs and videos of me during classes and events
which may be used for promotional purposes if I do not wish to be photographed or filmed, I will
inform the instructor in writing.
Recording And Posting Restrictions
I understand that recording or posting class content including videos images or any instructional
material is strictly prohibited unless I have received explicit written permission from the studio.
Violation of this policy may result in termination of my participation in classes.
Governing law
This waiver shall be governed and construed in accordance with laws of the State of Rhode
Island if any provision of this waiver is deemed invalid or unenforceable the remaining
provisions shall continue to be valid and enforceable.
Acknowledgement of Understanding
I have read this waiver and release of claims in its entirety. I understand the risks involved and
voluntarily agree to the terms and conditions set forth herein.
Participant signature:
Date:
Parent/ Guardian Signature:
Date:
Parent/Guardian Printed Name:
