Particpant Waiver & Photo Release

All students must submit a Participant Waiver prior to engagement in any studio activity, class or event.

First Name

Email Address

Last Name

Phone

Date of Birth

Emergency Contact Number

Have you been hospitalized in the last 12 months?

Yes

Are you currently suffering from a medical condition, illness, or injury?

Yes

If you answered yes to any question, please elaborate

Liability Terms & Conditions

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN THIS ACTIVITY OR EVENT, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.

I certify that I am physically fit, have sufficiently prepared or trained for participation in the activity or event, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity or event.

I certify that I am in good health and that I do not pose a health risk to the public.

I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity or event in which I may participate, and that it will govern my actions and responsibilities at said activity or event. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:

I HEREBY WAIVE, RELEASE, AND DISCHARGE “Elite Latin Dance” & “Quinlan Khan Dance” and all divisions thereof of any and all liability and responsibility for injuries, sickness, pandemics, accidents, natural disasters and/or acts of God incurred during participation in and/or instruction of, group lessons, private lessons, or any activity I may participate.

I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: “Quinlan Khan Dance” operating as “Elite Latin Dance” and their employees, volunteers, or the activity or event holders, activity or event sponsors, activity or event volunteers.

I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this waiver, release and registration form from any and all liabilities or claims made as a result of participation in this activity or event, whether caused by the negligence of release or otherwise. The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL. PARENT / GUARDIAN WAIVER FOR MINORS (Only if student is under 18 years old) The undersigned parent and natural guardian does hereby represent that he/she is, in fact, acting in such capacity, has consented to his/her child or ward’s participation in the activity or event, and has agreed individually and on behalf of the child or ward, to the terms of the accident waiver and release of liability set forth above. The undersigned parent or guardian further agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor, the parents, of the legal guardian.

Participant’s Signature (if under 18 years old, Parent or guardian must sign)

Today's Date

Photo/Video Release: I acknowledge and consent to allow “Elite Latin Dance” to use: photos and/or videos of my child/myself in publications (such as flyers/brochures), advertisements (such as newspapers or online ads), our studio’s website, or on social media sites (such as the studio’s facebook or instagram account). I understand that in some cases, my child and/or my name may be used. I further understand no financial compensation will be given for use of these photos/videos.

I Consent

I Do Not Consent

Thanks for submitting!

Oakville | Hamilton

Particpant Waiver & Photo Release

ELITE

EXPERIENCE

JOIN OUR NEWSLETTER

FOLLOW US