Dance Participation & Injury Waiver
Dance is a physical activity that involves movement, exercise, stretching, strength, balance, coordination, and physical contact. Participation in dance classes, rehearsals, performances, workshops, intensives, and other activities offered by The School of Rochester City Ballet (“School of RCB”) involves inherent risks.
I understand that participation in dance and other physical activities may result in injuries, including, but not limited to, muscle strains, sprains, bruises, falls, fractures, and other injuries. I understand that injuries may occur even when proper instruction, supervision, equipment, and safety precautions are provided.
I acknowledge that participation in School of RCB activities is voluntary and that I am responsible for determining whether I am physically able to participate. I agree to inform the School of RCB and/or its instructors of any injury, limitation, or condition that may affect my ability to safely participate in physical activity.
I understand that students are expected to follow the instructions and safety guidelines provided by School of RCB instructors and staff. I agree to encourage the student named below to participate responsibly and to immediately report pain, injury, illness, or other concerns to an instructor or staff member.
To the fullest extent permitted by law, I acknowledge and accept the inherent risks associated with participation in dance and physical activity at the School of RCB.
Emergency Medical Authorization
School of RCB staff members are CPR certified and trained to respond to emergencies within the scope of their training. However, staff are not medical professionals and CPR certification does not constitute medical diagnosis or treatment.
In the event of an emergency, I authorize School of RCB staff to seek appropriate medical attention for the student when I cannot be reached or when circumstances reasonably require immediate attention. This may include contacting emergency medical services (911) when appropriate.
I understand that School of RCB staff will take reasonable steps to respond to an emergency but cannot guarantee the prevention of injury or other medical complications.
Acknowledgment and Agreement
By signing below, I acknowledge that I have read and understand this Dance Participation & Injury Waiver. I understand the physical nature of dance and the inherent risks associated with participation. I voluntarily consent to the student’s participation in School of RCB activities and agree to the terms of this waiver to the fullest extent permitted by law.
Student Name: ______________________________________________
Parent/Guardian Name (if student is under 18):

Parent/Guardian Signature: ___________________________________
Date: ______________________
Student Signature (if applicable): ______________________________
Date: ______________________
Emergency Contact Name: ____________________________________
Emergency Contact Phone: ___________________________________