ACKNOWLEDGEMENT, MEDICAL RELEASE, PERMISSIONS, AND WAIVER OF LIABILITY: To be e-signed by performer or performer's guardian if performer is a minor.
I hereby acknowledge my receipt and understanding of the information disclosed on this registration form. I hereby grant permission to the Fused Dance Center staff and instructors to obtain medical care from any licensed physician, hospital, medical clinic or emergency medical service organization for the above named at such times as deemed necessary for physical health purposes. I waive all claims against and agree not to sue the Fused Dance Center, L.L.C., its officers, agents, and employees as a result of my or my child's participation in the above activities including any decision or action regarding medical care for me or my child. I grant permission for my child's pictures, likeness, videos, ect. to be used by Fused Dance Center on their website, in newsletters and in any form of advertising/marketing for Fused Dance Center, L.L.C. without compensation.