Medical Release/Hold Harmless
Feb 03, 2026 08:28 PM
I/We, __________________________________________, intending to be legally bound, do hereby enroll my child in the dance program of Dancentre of Edinburg, accepting the risks of the various dance activities, and do hereby waive claim and release Dancentre of Edinburg and/or its staff and instructors and other personnel for claim or liability for any injury or accident occurring or arising from the instructional program or incidental sponsored activities, either on or off premises.
_______We do _______We do not (check one) hereby consent to appropriate physical contact of named student that is necessary for instruction or correction by the instructor(s) and/or aide(s).
*If you do not consent, please inform the front desk IN WRITING.
Permission for Medical Treatment
_______We do _______We do not (check one) authorize emergency and first aid care to be administered to said student by the school in the event he/she becomes injured or ill during the instructional program or sponsored activities, either on or off the premises. School will immediately notify parent of accident, injury or illness. I further authorize school staff and/or their agents to retain the services of a doctor or other medical personnel in order to treat said minor, should treatment be deemed necessary. I assert that my child is physically and emotionally capable of performing the physical activities required in this program, and is only limited by the medical conditions specified in the student data sheet. Dancentre of Edinburg urges that the student undergo a complete physical examination before beginning these activities.
* If you DO NOT agree, Please inform front desk IN WRITING.
I represent that I am the parent or legal guardian of the named minor student, or I am a participant over the age of 18, and in order to induce you to accept this document on behalf of said minor and myself, agree to be bound by all the terms and conditions of this liability release, in the same manner as if I were the participant.
Each of us hereby releases Dancentre of Edinburg and its directors, teachers, volunteers, and employees from any and all liabilities. With the acceptance of this form, the undersigned hereby agrees to indemnify and hold harmless Dancentre of Edinburg and its directors, teachers, volunteers and employees from any and all liabilities in connection with Dancentre of Edinburg.
PHOTOGRAPHIC RELEASE
We understand and agree that for promotional, publicity or commercial advertising purposes, Dancentre of Edinburg & Edinburg Dance Theatre shall have the right to use a photograph, video, voice or other likeness of the student.