DTU 2020-2021 Medical Waiver
*Please only complete this form ONCE per participant. You will receive a confirmation email once this form has been submitted.
AGREEMENT, WAIVER, RELEASE OF ALL CLAIMS, HOLD HARMLESS AND COVENANT NOT TO SUE DANCE TEAM UNION
By their very nature, Dance Team Union’s dance camps and dance competitions involve dancing (which may include, among other things depending on your team’s specific routine, stretching, body contact, substantial physical exertion, strenuous movement, and/or emotional stress). Dancing, and/or attending a dance camp or competition, represents a certain risk. It is recommended that you check with your physician prior to participating in Dance Team Union’s dance camps and/or dance competitions. Our virtual camps are intended to be completed by each individual dancer in their own individual dance space. Dance Team Union undertakes no responsibility for the safety of such space including whether such space is free from the possibility of exposure to the coronavirus COVID-19 (“COVID-19”). Similarly, Dance Team Union undertakes no responsibility with respect to COVID-19 exposure for teams or groups of individuals that choose to engage in this camp in a group or partial group setting.
Note that competitive dancing is considered aerobic activity, which, despite careful and proper preparation, instruction, medical advice, conditioning and equipment, still presents a substantial risk of injury. Depending upon a person’s physical condition, age and skill level, dancing can involve a substantial risk of the following types of injuries. This list is by no means complete, but includes some of the more common ones: heart attack, stroke and circulatory problems, lacerations, bone and joint injuries, back injury, shin splints, muscle strain and other muscle, tendon or ligament injuries, foot or hand problems, head, neck or shoulder injuries.
Dance Team Union does not provide insurance or protection against injuries of any kind sustained by participants in its dance team camps and/or competitions. Please read the information in this agreement carefully and be aware that in participating (or allowing your minor child/ward to participate) in Dance Team Union’s camps and/or competitions, you will be waiving and releasing all claims for injuries you or your child/ward might sustain arising out of the event(s).
Having read the foregoing, the undersigned hereby agrees as follows:
(1) REPRESENTATION AND WARRANTY: If I am of the age of majority in the state in which the applicable Dance Team Union competition is being held, I represent and warrant to Dance Team Union that I have no physical or mental condition that would injure myself or others if I participate in this event, or would interfere with my ability to participate in this event. If I am a parent/guardian for a minor participant in this event, I represent and warrant to Dance Team Union that my child/ward has no physical or mental condition that would injure him or herself or others if he/she participates in this event, or would interfere with his/her ability to participate in this event.
(2) AGREEMENTS: I agree to follow all laws and rules of competition associated with this event. I also agree that it is my sole responsibility to be familiar with the physical and/or mental demands associated with this event. I understand and expressly assume and accept all of the risks and dangers of dance, dance performances and any other activities contemplated at Dance Team Union camps and competitions and under this agreement. I acknowledge that Dance Team Union assumes no responsibility for personal injury or property loss in connection with any Dance Team Union camp or competition.
(3) GENERAL WAIVER AND RELEASE: I read and understand everything in this agreement and give permission for my child/ward/self to participate in this event. I hereby release, waive, discharge and covenant not to sue the host property, Dance Team Union, LLC, and their respective owners, members, officers, agents, servants, volunteers and employees (collectively, the “Released Parties”) for and from all liability, claims, demands, actions, or causes of action whatsoever arising out of any damage, loss, or injury to me, my child/ward, or my property while participating in any Dance Team Union camp or competition, whether such damage, loss or injury results from the negligence of the Released Parties or from any other cause whatsoever. I also hereby release, waive, discharge and covenant not to sue the Released Parties for and from any claims whatsoever on account of any first aid, treatment, or service rendered to me or my child/ward during my participation in any Dance Team Union camp or competition.
(4) INDEMNITY AND HOLD HARMLESS: I hereby agree to indemnify and hold harmless the Released Parties from any loss, liability, damage or cost, including court costs and attorneys’ fees, that any Released Party may incur due to my participation in any Dance Team Union camp or competition, whether caused by the negligence of the Released Parties or otherwise.
(5) PHOTO RELEASE: I understand that my child/ward or I may be photographed or videotaped while participating in any Dance Team Union dance camp or dance competition. I give my permission for photos and videotapes of my child/ward or myself to be used to promote Dance Team Union. Such photos and videotapes will remain the property of Dance Team Union.
School Name or Studio Name
Do not just type "JV Pom". We need the name of your program. Do not abbreviate. For example, do NOT type CHS Dance Team. DO type Central High School Dance Team.
Please type the full name of the participant.
Please input the birth date of the participant
Please type the full name of the participant's parent or guardian.
Please type the full name of the participant's emergency contact.
What is the relationship of the emergency contact to the participant?
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Please type an alternate phone number for the emergency contact.
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