Due to the nature of the exercises undertaken by the students of a dance class, parents are warned that children suffering from asthma, orthopedic injuries or degenerative back complaints should seek advice from an appropriate medical practitioner, or specialist, before enrolling a student in the dance class. All reasonable care will be taken for the welfare of the students; however, Andrea Lagodny will assume no responsibility in the case of injury or accident to any student. In the event of a medical emergency and where a parent cannot be contacted, I authorize Andrea Lagodny to seek medical advice and treatment. This agreement fully represents all terms and considerations and no other statements, conditions, or promises are made in conjunction with this release form. I give permission to Andrea Lagodny to use, without charge and without reservation, my likeness in any medium and for any lawful purpose, including promoting the institution, its programs and services. I waive any rights of action I may have and release Andrea Lagodny from any and all claims I may have arising from use of my likeness, including any rights to sue for defamation or violation of my rights of privacy or publicity.


             Signature:                                                                       Date:

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© 2018 Ever Be Ballet

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