Please review and accept the following terms and conditions for participation: I understand that risk of injury is inherent in any physical activity and I knowingly and voluntarily accept that risk. I, the undersigned, for myself, my heirs, administrators, and executors, hereby waive and release Wanda Lloyd, individually, and/or Smooth Flava Dance - Gainesville Chapter and its staff from any and all claims or damages of any kind arising out of my participation in the exercise and/or dance program of Smooth Flava Dance. I certify that I am in proper physical condition to participate in the exercise/dance program and that I have been examined by a licensed physician and found to be in proper physical condition to participate in said dance classes. I, the undersigned, do hereby authorize Smooth Flava Dance or it's designated agents (being volunteer or paid teachers or administrators employed by Wanda Lloyd and/or Smooth Flava Dance) to obtain medical treatment for myself in emergency situations if needed. I understand that I am responsible for any medical expenses and that the absence of health insurance does not make Wanda Lloyd and/or Smooth Flava Dance responsible for payment of medical expenses. This authority includes the power to authorize any and all treatment deemed necessary under the circumstances by a licensed physician. This power is in essence a power of attorney and shall remain in effect for one year from the date signed below. *
