$55 Application fee is due at the time of application to the financial aid assessment service, not on receipt of this form. If the application fee is a barrier, please email academy@theportlandballet.org for more information.
*As an organization funded by the Regional Arts and Culture Council, we are partnering with RACC and the City of Portland on a diversity initiative. We are asking for your support in moving this initiative forward. Please answer the following questions:
RELEASE OF LIABILITY
I acknowledge that dance instruction is strenuous physical activity involving the risk of physical injury and have taken all steps necessary to learn of any physical impairment(s) that would limit or affect my safe participation. I voluntarily assume all risks arising from my participation in dance instruction and hereby release and waive all claims against The Portland Ballet (TPB), any instructor contracted by TPB to provide dance instruction, and any and all of the other participants in class for any damages arising out of my instruction, demonstrations, or performances. I further agree to hold harmless and indemnify The Portland Ballet, any instructor contracted by TPB to provide dance instruction, and any and all of the other participants in class from any loss, cost, or expense, damage or injury arising from my participation in dance instruction, demonstration, or performances.
*PUBLICITY RELEASE AND HOLD HARMLESS
I hereby authorize and give full consent to The Portland Ballet to write, publish, and prepare articles, photographs, videotapes, or DVDs concerning my activities in connection with TPB. TPB may use, or cause to be used, these articles, photographs, videos or DVS for any and all exhibitions, public displays, including website, email and social media platforms, commercial art for advertising purposes, without limitation, reservation or compensation.
I specifically waive and relinquish any and all rights to videotaping and sound recordings of my activities described above with full knowledge videotaping may subsequently be distributed for showing to the public, and I further waive and relinquish any and all rights with respect to such distribution and showing.
I agree to hold TPB and its agents free and harmless from all liabilities resulting from their active or passive negligence, but not from willful negligence, causing injury to me or to my property.
*Release of Liability: Acknowledgment of Risk
I hereby acknowledge and agree that participation in TPB activities comes with inherent risks. I understand the inherent risks associated with participation in TPB activities, including but not limited to slips, trips, and falls, athletic injuries, and illness, including exposure to and infection with viruses or bacteria. I further acknowledge that the preceding list is not inclusive of all possible risks associated with TPB program participation.
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