I hereby certify that my child is physically and emotionally capable in participating in this dance program. I hereby release, absolve, indemnify and hold harmless Mass Ballet, and any employee, contractor or volunteer, of any accident or injury that may occur as a result of this extra-curricular activity, its sponsored activities and performances. I give Mass Ballet permission to use any video and photographs taken of my child in class, rehearsals, and performances for website and promotional purposes (names are not used). Please type initials below. *