* indicates required field

We will pick children up from classrooms at 11:30 am and gather to dance.

By submitting the above form, I, the undersigned, a parent or legal guardian of the participating individual (the “Participant”), hereby agree to the following participation waiver and limitation and release of liability to Bitty Ballet LLC (the “Company”): Participation in any and all physical activities can be inherently dangerous and, regardless of due care taken to avoid injury, it is impossible to guarantee the safety of all Participants. Dance activity is no exception to the hazards attenuated to other physical activities. Dance is a sport that demands cardiovascular fitness, coordination, and agility.

I, the undersigned, certify that Participant possesses a sufficient degree of physical fitness to safely engage in dance activity, will indicate below any health-related conditions that might affect Participant’s ability to engage in dance activity, will immediately and verbally inform the dance instructor(s) if Participant feels undue discomfort or stress, and will immediately discontinue dance activity should illness or injury occur. In the event of a medical emergency, the Company will call Emergency Medical Services to render aid and I, the undersigned, will be financially responsible for any and all expenses incurred. To reduce the risk of injury, Participant is expected to abide by the rules set forth by the Company and the dance instructor(s). Participant shall follow all safety rules, written, posted, or otherwise stated. Participant will constantly remain aware of his or her surroundings and diligently avoid risk as possible. Participant is voluntarily registering and engaging in dance activity and, in doing so, assuming all inherent risk of the physical activity involved.

In consideration of permission to engage in dance activity, I, the undersigned, on behalf of myself, my family, heirs, and assigns, hereby release the Company or its agents, employees, independent contractors, and assigns from liability for injury, loss, or death to Participant while using any facility or equipment, during dance activity or while on the premises, or in any way associated with the Company, now and in the future, resulting from the ordinary negligence of the Company or its agents, employees, independent contractors, and assigns. Further, I, the undersigned, hereby consent and agree that the Company shall have the right to take photographs of Participant for use on the Company’s website and promotional materials. Compensation for any photographs will not be provided. Participant’s name and identity will not be revealed; the use of the Participant in promotional photography can be stopped at any time upon written request via email.