Liability Waiver/Photo Release
All students must complete and sign this form before taking classes at Next Level Dance
Company. If the participant is under age 18, a parent or guardian must also sign this form.
Admission to class will not be granted until this form is received and properly signed.
I, _____________________________, recognize and understand the risks of physical injury
inherent to the activity of dance and dance training, and I fully assume those risks. I hereby
release Next Level Dance Company, employees and dance teachers from all liability for injuries
sustained or illnesses contracted by my child or me while attending or participating in any
dance classes or workshops. I agree to indemnify, defend and hold harmless Next Level Dance
Company, employees and dance teachers for liabilities, costs and judgments arising from acts
of omissions committed by me or my child which result in injury or damage to any person or
property.
I understand and agree that it is my sole responsibility to safeguard my personal property while
attending or participating in any classes, events, or workshops. I hereby release Next Level
Dance Company, employees and dance teachers from all liability for loss or damage to my
personal property while attending or participating in classes, events, or workshops. I also agree
to abide by any rules, regulations and policies set forth by Next Level Dance Company.
I acknowledge and understand that Next Level Dance Company instructors may prohibit the
taking of photos and videos. I agree that I will honor any such restrictions imposed.
In case of physical injury or medical emergency, I hereby authorize Next Level Dance Company
to make necessary arrangements to transport my child or me to a medical treatment facility as
necessary. All such transportation and medical treatment will be at my sole cost and expense.
In extreme emergency, or if I am under 18 years old, I understand that Next Level Dance
Company will attempt to notify the person(s) named below as my emergency contact(s) of my
condition and how to reach me.
In signing this Release, I acknowledge and represent that I have fully informed myself of the
content of the waiver and hold harmless agreement by reading it before I sign it, and I
understand that I sign this document as my own free act and deed. No oral representations,
statements, or inducements, apart from the written statement, have been made. I further state
that I am at least 18 years of age and fully competent to sign this agreement; and that I execute
this release for full, adequate, and complete consideration fully intending to be bound by the
same. I further state that there are no health-related reasons or problems, which preclude or
restrict my participation in this activity, and that I will pay any medical costs that may be
attendant as a result of injury to my child or me.
Next Level Dance Company reserves the right to use photographs of students participating in
class, events or performances for the purposes of instruction, advertising and promoting Next
Level Dance Company and its programs. Students, or parents of students, who do not wish to
comply with this policy must notify Next Level Dance Company prior to participation in their
programs.
Participant’s Name: _______________________________
Parent/Guardian Signature: ____________________________
