Dancer Info
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Emergency Info
Allergies / Medical Conditions:
Emergency Contact #1
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First Name
Last Name
Relationship to Dancer:
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Mother
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Male Guardian
Cell Number:
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Emergency Contact #2
First Name
Last Name
Relationship to Dancer:
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Mother
Father
Spouse
Partner
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Boyfriend
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Nanny
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Aunt
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Cell Number:
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Miscellaneous
How did you find us?
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Class Interests:
Why do you want to dance?
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Waiver & Consent
Permission Statement & Release of Liability
► I, the undersigned, or legal guardian of participating dancer, hereby irrevocably and unconditionally release and hold harmless from liability TAP FEVER STUDIOS, its trustees, agents, and any instructors or board members associated with its programs from any and all liabilities, claims, actions, damages, costs or expenses of any nature whatsoever whether in law or equity, known or unknown, occurring during, caused by, relating to, or arising in any way from participation in TAP FEVER STUDIOS classes and/or performances. ► I understand that attending a dance class and/or performance involves participation in physical activities. With this and all dance related activities, there is a certain element of risk. By accepting this waiver, I hereby acknowledge that my, or my child’s participation is at my/their own risk, and that I assume all responsibilities for any and all aspects of participation. This waiver applies to any and all classes and performances offered by TAP FEVER STUDIOS. ► I understand that this Release from Liability irrevocably and unconditionally releases and holds harmless TAP FEVER STUDIOS, its trustees, agents, and any instructors associated with its programs, from any financial liability for any injury, bodily harm, sickness, illness, or loss of life the participant may suffer and from any economic harm or loss of property occurring during, caused by, relating to, or arising in any way out of the above events. ► As a participant in TAP FEVER STUDIOS classes and/or performances, I permit TAP FEVER STUDIOS to use audio, visual and photographic recording during the course of classes and/or performances. This material is primarily for archival purposes, but may also be used for promotional purposes and on the organization's website. ► I also acknowledge that I will be signed up on the TAP FEVER STUDIOS email list to receive information about upcoming events and/or messages about my dance account status.
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I have read this Release from Liability and understand all of its terms and significance.
I have executed this Release from Liability voluntarily and will be legally bound by it.
Dancer's Name:
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