Please enter the child's name and D.O.B as the member.

RELEASE OF LIABILITY WAIVER & INDEMNITY AGREEMENT

CHILD NAME: {name}

PARENT NAME: {contact_name}

PHONE NUMBER: {phone}

I, the undersigned, hereby acknowledge that certain risks of injury are inherent to participation in recreational activities and athletic activities. These risks and dangers may be caused by the action, inaction or negligence of the participant or others. There may be other risks not known or reasonably foreseeable at this time.

I, the undersigned accept and assume such risks and responsibility for the losses and/or damages following such injury, however caused, and whether caused in whole or in part by the negligence of the Participant named above.  I have thoroughly read the information brochure and understand the intensity of the given activity. If the above Participant has a temporary restriction (sickness, sprain or soreness) I will inform the appropriate instructor on a daily basis in writing.

Having read the above statement I am aware of the inherent risk of injury involved in athletic participation. Finally, I understand that in accepting the risks associated with athletic participation I will also share the responsibility of minimizing those risks.

I/WE HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE the __MERMAID TAILS DANCE___ facility used by the participant, including its owners, managers, instructors of premises used to conduct classes in our dance program.

On behalf of the participant and individually, the undersigned partner(s) and/or legal guardian(s) for the minor participant executes this Waiver and Release.  If, despite this release, the participant makes a claim against any of the Releasees, the parent(s)and/or legal guardian(s) will reimburse the Releasee for any money, which they have paid to the participant, or on his behalf, and hold them harmless.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Facility: MERMAID TAILS DANCE

Parent or Guardian Signature:

DATE:{sign_date}

MINOR CHILD PHOTO RELEASE WAIVER

I {contact_name} the parent or legal guardian of {name} grant   Mermaid Tails Dance & Marco Sharks MMA LLC, Kristin Utecht-Croscenco & Danilo Croscenco      for any legal use, including but not limited to; publicity, copyright purposes, illustration, advertising, and web content.

Furthermore,  I Understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

Parent/Guardian’s signature:

Date: {sign_date}

Parent/Guardian’s Name: {contact_name}

Phone Number {phone}

Child"s Name: {name}