Liability Waiver

Please read and sign the Assumption of Risk, Liability Waiver and Indemnification policy

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Name of the Student *

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Name of the person signing this Liability Waiver *

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Middle

Last

Relationship to the Student *ParentGuardianSelf (for Adult Ballet)

Phone Number *

Email *

ASSUMPTION OF RISK, LIABILITY WAIVER AND INDEMNIFICATION *

Today’s Date

I understand and agree that participation in any class, lesson, workshop, rehearsal, performance or other activity conducted by Southwest Florida Ballet, Inc. (SWFL Ballet) poses the possibility of injury, loss, damage or death. I agree, therefore, to assume, all risks and responsibility for any such injury, loss, damage or death which might occur to me (or my child) by reason of any SWFL Ballet class, lesson, workshop, rehearsal, performance or other activity. I also agree to waive, release and discharge Southwest Florida Ballet, Inc (SWFL Ballet), its members, officers, directors, agents, volunteers, assistants, employees, guest artists and faculty members from any and all losses, damages, liability, claims, demands or causes of action of any kind that may arise out of my (or my child’s) participation in any classes, lessons, workshops, rehearsals, performances or other activities conducted by SWFL Ballet. I further agree to indemnify and hold harmless SWFL Ballet, its members, officers, directors, agents, volunteers, assistants, employees, guest artists and faculty members from any and all losses, damages, liability, claims, demands or causes of action of any kind, including reasonable attorneys’ fees, that may arise out of my (or my child’s) participation in any SWFL Ballet class, lesson, workshop, rehearsal, performance or other activity. If I am signing this assumption of risk, liability waiver and indemnification on behalf of my child, I represent that I am authorized to do so and acknowledge that my child shall be bound by the assumption of risk, liability waiver and indemnification provisions contained herein. The assumption of risk, liability waiver and indemnification provisions contained herein shall also apply to my (or my child’s) heirs, successors and assigns. By enrolling in SWFL Ballet you give us permission to take and use photos and videos of you (or your student) for marketing purposes on our website or social media platforms. *

Please confirm your acknowlegement of the Liability Waiver policy *

• I have read, understood and ACCEPT the Assumption of Risk, Liability Waiver and Indemnification policy
• I DO NOT accept the Assumption of Risk, Liability Waiver and Indemnification policy

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