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Student Name *
Student Birthdate *
Parent First & Last Name *
Email *
Phone number *
I (we) despite all reasonable precautions implemented for safety, am (are) fully aware of and appreciate that severe injuries, including permanent paralysis or even death, as well as other damages and losses associated with participation in VIP Dance Studio (Venga Dance Productions) online programs can occur. I (we) knowingly and willingly assume all such risks. Being fully aware of these dangers, I hereby give consent for my child(ren) to participate in any and all VIP Dance Studio (Venga Dance Productions) online programs. In consideration for my child(ren's) participation, I (we) hereby for myself and my child(ren) and our respective heirs, executors and administrators, COVENANT NOT TO SUE and FOREVER RELEASE VIP Dance Studio (Venga Dance Productions), the owners, operators, directors, officers, employees and other members of VIP Dance Studio (Venga Dance Productions) from personal injury or accident of any sort or nature suffered by my children or me (us), the undersigned, by reason of participation or membership in classes, lessons or any programs or activities of VIP Dance Studio (Venga Dance Productions) including those resulting from acts of negligence. I also assume all medical expenses for the aforementioned child or myself, who may be the result of any injuries sustained while training at, or performing for VIP Dance Studio (Venga Dance Productions). Further, it is affirmed that sufficient insurance covering all such injuries and damages shall be in full force and effect throughout the program or it's equivalent throughout the child's/parent's dance participation. *
I hereby grant permission to VIP Dance Studio (Venga Dance Productions) to obtain, use, reproduce and publish or re-publish the name and/or likeness (photograph, digital, videotape, voice, electronic, or other likeness) of myself or my child, for commemorative, promotional, publicity, fundraising, commercial advertising or any other purpose, including but not limited to publication via the internet. I understand that there will be no compensation or other consideration for such uses. I waive any right to inspect or approve the likeness of myself or my child chosen to be used or the final version of any works in which my child's name or likeness is incorporated.I hereby release, discharge and agree to hold harmless VIP Dance Studio (Venga Dance Productions), from any and all claims, actions and liability relating to their use of said likeness of myself or my child, including but not limited to claims concerning blurring, distortion, optical illusion or use in composite form, whether intentional or otherwise, of myself or my child's name and/or likeness, and claims of libel or invasion of privacy. *
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