I CERTIFY that I am physically able, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I CERTIFY that there are no health-related reasons or problems which preclude my participation in this activity. 

I acknowledge that this Accident Waiver and Liability Release Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity.

In consideration of receiving permission to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: 

(1) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, RIRIE-WOODBURY DANCE COMPANY and/or their directors, officers, employees, volunteers, representatives, agents, activity holders, business locations, facilities, and sponsors; 

(2)I INDEMNIFY AND HOLD HARMLESS the entities mentioned above from any and all liabilities or claims made as a result of my participation in this activity, whether caused by negligence or otherwise.

I acknowledge that this activity may test a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people, including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are inherent to participants, organizers, and volunteers.

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity, and release RIRIE-WOODBURY DANCE COMPANY and its above constituents from providing payment for this treatment.

I grant Ririe-Woodbury Dance Company, their representatives and employees the right to take photographs and videos of me and my property in connection with the above-identified subject. I authorize Ririe-Woodbury Dance Company, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Ririe-Woodbury Dance Company may use such photographs or videos of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. 

The Accident Waiver and Liability Release Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND I SIGN IT OF MY OWN FREE WILL.