Dance Performance Waiver Form
Please read and complete this waiver form before participating in the dance performance.
Participant's Full Name
First Name
Last Name
Date of Birth
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Full Name (if participant is under 18)
First Name
Last Name
Emergency Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Do you acknowledge and accept the risks associated with participating in the dance performance?
Yes
No
Signature of Participant or Parent/Guardian
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Should be Empty: