Bring a Friend Week January 2020!
Thank you for joining us at Oregon Irish Dance Academy's Bring a Friend Week! The week of January 19th through 25th, 2020, all of our OIDA dancers at our Portland location, The Children's Gym, are invited to bring a friend to their dance class. Your child gets to attend and fully participate in the class, free of charge! No dance shoes required - just wear socks and easy-to-move-in clothes. Please fill out the form below by January 19th. We will then send you a confirmation email (which will include our front door code). Let us know if you have any questions - we are happy to help!

Oregon Irish Dance Academy
Non-Competitive Irish Dancing for Ages 3 to Adult
Email address *
What is your child's name? *
Your answer
Emergency Contact Name and Phone Number *
Your answer
Which OIDA dancer is bringing your child as their guest? *
Your answer
Which class day and time will you be attending? *
Your answer
Required Policies and Agreements

Media Release: I agree that photos and/or videos of my child can be used on OIDA fliers, handouts, websites, advertisements, and social media. I acknowledge that if I wish to opt out of this media release, I will need to fill out an opt-out form (email us to request one).

Medical Emergency: The undersigned gives permission to Oregon Irish Dance Academy LLC, its owners and operators to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I hereby declare any physical/mental problems, restriction, or condition (enter in your student's notes) and/or declare the participant to be in good physical and mental health. I request that our doctor/physician (enter in your student's notes) be called and that my student be transported to (enter in your student's notes) hospital. Please include physician's phone number (enter in your student's notes).Oregon Irish Dance Academy

Waiver of Liability and Hold Harmless Agreement

a. In consideration for receiving permission to participate as a student of and recipient of services of the Oregon Irish Dance Academy LLC, I hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE Oregon Irish Dance Academy LLC, its officers, agents, or employees (hereinafter referred to as RELEASEES) from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, while participating in such activity, while in, on or upon the premises where the activities are being conducted, REGARDLESS OF WHETHER SUCH LOSS IS CAUSED BY THE NEGLIGENCE OF THE RELEASEES, or otherwise and regardless of whether such liability arises in tort, contract, strict liability, or otherwise, to the fullest extent allowed by law.

b. I am fully aware of the risks and hazards connected with the activities of the Oregon Irish Dance Academy, which include, but are not limited to, Irish dance classes and performances, gymnastics and other athletic activities. I am aware that such activities, which expose the participants to the usual risk of cuts and bruises, also exposes participants to more serious injuries, including falling off of equipment, spraining or breaking wrists and ankles, and even death, and I hereby elect to voluntarily participate in said activities, knowing that the activities may be hazardous to my property and me. I understand that Oregon Irish Dance Academy LLC does not require me to participate in this activity. I voluntarily assume full responsibility for any risks of loss, property damage, or personal injury, including death, that may be sustained by me, or any loss or damage to property owned by me, as a result of being engaged in such activities, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES or otherwise, to the fullest extent allowed by law.

c. I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS the RELEASEES from any loss, liability, damage, or costs, including court costs and attorneys' fees that Releases may incur due to my participation in said activities, WHETHER CAUSED BY NEGLIGENCE OF RELEASEES or otherwise, to the fullest extent allowed by law.

d. I HEREBY CERTIFY that I have personal health insurance.

e. It is my express intent that this Waiver and Hold Harmless Agreement shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a RELEASE, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE the above-named RELEASEES. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be construed in accordance with the laws of the State of Oregon and that any mediation, suit, or other proceeding must be filed or entered into only in Oregon and the federal or state courts of Oregon. Any portion of this document deemed unlawful or unenforceable is severable and shall be stricken without any effect on the enforceability of the remaining provisions.

IN SIGNING THIS AGREEMENT, I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Wavier of Liability and Hold Harmless Agreement, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this Agreement for full, adequate and complete consideration fully intending to be bound by same.

The Children's Gym
In consideration of the services of The Children's Gym, here in after collectively referred to as ("TCG"), their agents, owners, officers, employees, and all other person or entities acting in any capacity on their behalf, I hereby agree to release and discharge TCG, on behalf of myself, my children, my heirs, assigns, personal representative and estate as follows:

1. I understand and acknowledge that the activity my child is about to engage in poses known risks and unanticipated risks which could result in injury, paralysis, death, emotional distress, or damage to my child, property, or to third parties.

The following describes some, but not all, of those risks: Gymnastics, dance, cheer and fitness classes entails certain risks that simply cannot be eliminated without jeopardizing the essential qualities of the activity. Without a certain degree of risks, students would not improve their skills, and the enjoyment of the sport would be diminished. Gymnastics, dance, cheer and fitness classes exposes its participants to the usual risk of cuts and bruises. Other more serious risks exist as well. Participants often fall off equipment, sprain or break wrists and ankles, and can suffer more serious injuries as well. Traveling to and from shows, meets and exhibitions raises the possibility of any manner of transportation accidents. In any event, if your child is injured, your child may require medical assistance, at your own expense.

2. I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, no one is forcing me or my child to participate, and we elect to participate in spite of the risks.

3. I hereby voluntarily release, forever discharge and agree to hold harmless and indemnify TCG from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my child's participation in this activity.

4. Should TCG, or anyone acting on their behalf, be required to incur attorney's fees & costs to enforce this agreement, I agree to indemnify and reimburse them for such fees and costs.

5. I certify that my child has health, accident and liability insurance to cover any bodily injury or property damage that may be caused or suffered while participating in this event or activity, or else I agree to bear the costs of such injury or damage to my child. I further certify that I am willing to assume the risk of any medical or physical condition my child may have or else I am willing to assume and bear the costs of all risks that may be created, directly or indirectly, by any such condition.

6. In the event that I file a lawsuit against TCG, I agree to do so solely in the state of Oregon, and I further agree that the substantive law of that state shall apply in that action without regard to the conflict of law rules of that state. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against TCG on the basis of any claim from which I have released them herein.

I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound to its terms.

In consideration of "enrolling student" being permitted by TCG to participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless TCG from any and all claims which are brought by, or on behalf of Minor, and which are in any way connected with such use or participation by Minor.
Required for Your Child to Participate *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy