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Reverence
Academy of Dance Parent Liability Waiver 2008-09:
FIRST DAY OF
CLASSES AUG. 25TH
Register Now
READ AND SIGN BELOW
REGISTRATION IS INCOMPLETE WITHOUT SIGNATURE AND MUST BE
COMPLETED BEFORE CLASS
I,
______________________________ of (address) ___________________, in
the City of ________________, and State of Colorado, hereby
authorize Reverence Academy of Dance, LLC, 1370 Miners Dr. Suite
103, Lafayette, CO, 80026, and all of its employees, agents, and
representatives to instruct me / my child in the art of dance and
related activities. I recognize the inherent dangers associated with
such activities, including, but not limited to falling, twisting,
braking, and/or injuring limbs, hips, knees, elbows, neck, head,
paralysis, and related injuries. I understand that while Reverence
Academy of Dance, LLC, will take reasonable care during periods of
instruction, there are numerous injuries, which may occur in the
course of that instruction. I hereby release and absolve Reverence
Academy of Dance, LLC, its employees, agents, and representatives
from all claims and causes of action arising out of their care and
instruction.
I also understand that there are no refunds for
tuition, costume fees, performance fees, registration fees,
convention fees, or private lessons.
“I have
read and understand all of the above information in the Parent
Agreement, Liability Waiver and am willing to
comply with the policies set forth by the Reverence Academy of
Dance, LLC, its owners, Directors, and employees”.
PARENT SIGNATURE
____________________________ DATE _______________
(PRINTED NAME)
____________________________
STUDENT’S NAME
____________________________
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