A+W Dance Training
Participation Waiver

Parent/ Guardian's Name

Parent/Guardian's Last Name

Parent/Guardian's Email

Parent/Guardian's Phone Number

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Dancer's Name

Dancer's Date of Birth

Allergies/Medical Information

Emergency Contact Name

Emergency Contact Number

Relationship to Dancer

Any Other Information A+W Needs to Know About Your Dancer?

DANCER PARTICIPATION, ASSUMPTION OF RISK, RELEASE OF LIABILITY & EMERGENCY AUTHORIZATION

Please read this agreement carefully before signing. By signing below, I acknowledge that I have read, understand, and voluntarily agree to the terms of this Waiver and Release.

YES, I give A+W Dance Training permission to photograph and/or record the dancer and use those images or recordings for A+W promotional and marketing purposes.

NO, I do not give A+W Dance Training permission to use the dancer’s photograph or video for promotional or marketing purposes.

By checking the box below, I acknowledge that my electronic signature has the same intent as a handwritten signature for this agreement, to the extent permitted by applicable law.

I agree to the terms of this Waiver and Release and electronically sign this agreement.

Date

Month

Day

Year

Parent/Guardian Signature

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Thank you for helping us keep our dancers safe!

A+W Dance Training Participation Waiver

A+W Dance Training
Participation Waiver