Please consult your physician before starting any physical or exercise program. I, [STUDENT/GUARDIAN OF THE STUDENT], am in good physical condition and I understand that I am advised to adjust my participation as needed based on my abilities and stop if I experience noticeable pain or discomfort or shortness of breath. I will alert my instructor of any special needs or injuries that might affect my safety and security during class. I affirm that I alone am responsible for my decision to participate, and that by acknowledging below; I release Gateway Dance Theatre, and its instructors/partners of any liabilities for my health and safety while participating in classes at Gateway Dance Theatre. Additionally, I authorize GDT to photograph me/or my child, for photographs for use in publications and/or media presentations. If applicable, I authorize members of the media to photograph or video/film/my youth or me engaged in this workshop. I also authorize GDT and/or contracted researchers of GDT to involve my youth in outcomes measurement/evaluation of GDT programs. I understand that any data or information obtained from these activities will be treated with utmost confidentiality and my youth will not be individually identified as a participant. *
