PowerHouse Studios Winter 2023 Registration
Welcome to PHS! Winter 2023 Term Starts January 15th-March 25th
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Photo Release/Liability Waiver
All participants MUST complete this form

All participants and students must complete this form before participating in any classes or rehearsals at PowerHouse Studios (PHS). If a participant is under age 18, a parent or guardian must also sign this form. Admission to class and/or rehearsal will not be granted if this form is not received prior to class and is not properly signed.

Waiver of Liability

I recognize and understand the risks of physical injury inherent to dance and dance training and I fully assume those risks. I hereby release PHS, its employees, and dance teachers from all liability for injuries sustained or illnesses contracted while attending or participating in any dance classes, rehearsals, workshops, or performances. I agree to indemnify, defend, and hold harmless PHS, its affiliate dance studios, event sponsors, employees, and dance teachers for liabilities, costs, and judgments arising from acts or omissions committed by me or my child which result in injury or damage to any person or property.

Protection of Property

I understand and agree that it is my sole responsibility to safeguard my personal property while attending or participating in any classes, rehearsals, workshops, or performances. I hereby release PHS, its affiliate dance studios, event sponsors, employees, and dance teachers from all liability for loss or damage to my personal property while attending or participating in classes, rehearsals, workshops, or performances. I also agree to abide by any rules, regulations, and policies set forth by PHS

Medical Attention

In case of physical injury or medical emergency, I hereby authorize PHS to make necessary arrangements to transport myself or my child to a medical treatment facility as necessary. All such transportation and medical treatment will be at my sole cost and expense. In an extreme emergency, or if my child is under 18 years of age, I understand that PHS will attempt to notify the person(s) I have named below as my emergency contact(s) of my condition and how to reach me.

Photo Release

PHS reserves the right to use photographs and videos taken during classes, workshops, performances, or other affiliated events for the purposes of instruction, advertising, and promoting PHS and its programs. Students or parents of students who are minors, who do not wish to comply with this policy must notify PHS prior to participation in class.

Acknowledgment of Waiver

In signing this Release, I acknowledge and represent that I have fully informed myself of the content of the waiver and hold harmless agreement by reading it before I sign it, and I understand that I sign this document as my own free act and deed; no oral representations, statements, or inducements, apart from the written statement, have been made. I further state that I am at least eighteen (18) years of age and am fully competent to sign this agreement; and that I execute this Release for full, adequate, and complete consideration fully intending to be bound by the same. I further state that there are no health-related reasons or problems which preclude or restrict my or my child’s participation in this activity and that I will pay any medical costs that may be attendant as a result of injury to me or my child.
By typing your name below you acknowledge and agree to the above. (Guardian if under 18.)
Contact phone number/whatsapp *
Emergency contact if different from above and phone number *
Please list any medical conditions, injuries, or allergies, etc. *
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