WAIVER AND RELEASE


In consideration of my child's enrollment in the Studio 103 dance classes and programs, I agree that my child is in good enough physical condition to be a participant and I assume all risk of injury and other loss to myself and my child, and I waive and release all liability claims against Chelsea L. Kuchta, d/b/a Studio 103, all of her employees, agents and volunteers, and hold them harmless for any personal injuries, damages to personal property, or other losses of any kind arising out of my child's participation, save and except any actionable negligence on the part of the owner. I agree to obey any and all rules and regulations of Studio 103. I agree that my child shall wear appropriate dance shoes and attire while on the premises of Studio 103.


Signature _______________________________________________
Parent or Guardian of Participant under age 19



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Child's Name _____________________________________

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