LIABILITY WAIVER (Freaks With Lines, Studio C)

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Please complete this waiver before taking class

FIRST NAME *

LAST NAME *

EMAIL *

STREET ADDRESS + UNIT *

STATE *

ZIP CODE *

MOBILE PHONE *

DATE OF BIRTH *

YYYY

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE *

EMERGENCY CONTACT RELATIONSHIP *

Terms and conditions

This ballet technique program is based upon sound teaching practices and a deep understanding of biomechanics. Should you experience any pain, dizziness or nausea during any portion of the ballet technique program or if you feel you have sustained an injury stop immediately and inform the instructor. Agreeing to the aforementioned terms and conditions releases both Studio C and Freaks With Lines and thereby all of its instructors from any liability whatsoever, past, present and in the future relating to this ballet technique program.

I declare that I have filled out this questionnaire truthfully, comprehensively and to the best of my ability. I accept the above terms and conditions and agree to abide by them.

I accept and agree.

Required

Printing your full name below constitutes your digital signature and acceptance of the Terms & Conditions. *

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