Indicated in the space below are any health problems or conditions of which the Sweat Dance Movement/3DC Entertainment studio should be aware (such as heart, back, medical, allergy, muscular, pregnancy, diabetes, epilepsy, chemical or neurological condition, special medication, knee/kidney/shoulder problems, etc.). I understand that risk of injury is inherent in any physical activity and I, on behalf of myself and my child, knowingly and voluntarily accept that risk. I, the undersigned, for myself, my heirs, administrators, and executors, hereby waive and release Sweat Dance Movement/3DC Entertainment(SDM) and its staff from any and all claims or damages of any kind arising out of my child’s participation in the exercise and/or dance program of Sweat Dance Movement/3DC Entertainment. I further certify that the aforementioned student is in proper physical condition to participate in the dance program and that he/she has been examined by a licensed physician and found to be in proper physical condition to participate in said program. I, the undersigned, do hereby authorize Sweat Dance Movement/3DC Entertainment or its designated agents (being teachers or administrators Sweat Dance Movement/3DC Entertainment) to obtain medical treatment for my said child in emergency situations where I cannot be reached in time to authorize the treating physician to provide such emergency medical services. I understand that I am responsible for any medical expenses and that the absence of health insurance does not make Sweat Dance Movement/3DC Entertainment responsible for payment of medical expenses. This authority includes the power to authorize any and all treatment deemed necessary under the circumstances by a licensed physician. This shall remain in effect for one year from the date signed below.