AMB School Special Event Registration Form
Please fill out this form and mark the consent to participate in American Midwest Ballet School's special events.

We at American Midwest Ballet do everything in our power to ensure that our guests and participants in enrichment classes are safe and comfortable. If participants feel unwell, they are always encouraged to take a break. We ask that all participants submit the below release of liability for legal and insurance purposes. Thank you!

Masks are currently required in all classes.
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What event are you participating in? *
Name of Participant *
Name of Parent or Guardian (put N/A if adult) *
Phone Number of participant (or, if under 18, parent's phone number) *
Email address of participant, or of parent/guardian (if under 18)
ππ€π‘π“πˆπ‚πˆππ€π“πˆπŽπ π€π†π‘π„π„πŒπ„ππ“ 𝐀𝐍𝐃 𝐑𝐄𝐋𝐄𝐀𝐒𝐄 πŽπ… π‹πˆπ€ππˆπ‹πˆπ“π˜
LIABILITY RELEASES
 The undersigned, on his or her own behalf as a participant or otherwise and on behalf of any minor children participating in American Midwest Ballet (β€œAMB”) classes or other activities (each, a β€œParticipant”) of whom the undersigned is a parent or other legal guardian, and in consideration of each such Participant’s ability to participate in such classes or activities, agrees to and acknowledges the following discharges, releases, disclosures, terms and covenants with respect to such participation.

A. PHOTOGRAPHY/VIDEOGRAPHY/SOCIAL MEDIA RELEASE
Each Participant hereby consents to any and all uses and displays, by AMB and its agents, of Participant’s name, voice, likeness, image, appearance, and biographical information in, or in connection with any pictures, programs, photographs, audio and video recordings, digital images, billboards, posters, social media accounts, websites, television programs, radio programs, advertising, and other advertising, sales and marketing brochures, AMB archives, AMB choreography, AMB training or rehearsals, books, magazines, other publications, banners, marquees, CDs, DVDs, tapes, and all other printed and electronic forms and media throughout the world, at any time during or after the period of the Participant’s participation in AMB classes or other activities, for all legitimate business purposes of AMB as determined by AMB (β€œPermitted Uses”). Participant, on behalf of Participant and his or her successors and heirs, hereby forever releases and discharges AMB and its directors, officers, employees, volunteers, agents, contractors and representatives from any and all claims, actions, damages, losses, costs, expenses and liability of any kind, arising under any legal or equitable theory whatsoever at any time during or after the period of his or her participation in AMB classes or activities, in connection with any Permitted Use.  

DISCLOSURE OF PHYSICAL CONDITION
Each Participant hereby agrees, acknowledges and represents to AMB as of the date of signature below that each such Participant has no illnesses, abnormalities or impairments, physical or otherwise, which would prevent full participation in dance classes and activities except those communicated beforehand to the class or activity leader.

B. ASSUMPTION OF RISK AND RELEASE OF LIABILITY
Each Participant hereby assumes the risk and full responsibility for bodily injury, illness, exacerbation of existing illness or injury, or death of such Participant that may occur while he or she is participating in dance classes or other programs or activities of AMB due to any known or unknown illnesses, abnormalities or impairments or exacerbations of the same, of such Participant. In consideration of the opportunity to participate in AMB activities and classes, each Participant hereby releases, covenants not to sue, and will hold harmless AMB and all of its officers, employees, directors, volunteers, dancers, contractors, agents and representatives (each β€œReleased Person”) with respect to any and all liability actions, causes of action, debts, losses, damages, claims and demands of every kind or nature arising from or related to the negligent act or omission of Participant or a Released Person, which the Participant now has or which may arise out of, or in connection with, the Participant’s participation in AMB classes, programs or activities, including with respect to bodily injury, illness, exacerbation of injury or illness, loss of consortium/support or the like, loss or damage of personal property, or death. Each Participant agrees that this release of liability is intended to be as broad and inclusive as permitted by applicable law, and that if any portion of this release is later held invalid by a court of competent jurisdiction, that the remaining provisions shall, notwithstanding, continue in full legal force and effect to the greatest extent permitted by applicable law. Each Participant further acknowledges and agrees that he or she is solely responsible for the safeguarding of his or her personal property that he or she brings to AMB activities, programs or classes, and that, except with respect to the intentional and wrongful act of a Released Person, AMB is not responsible for any loss or damage of such personal property that may occur during or as a consequence of participation in any AMB activities, programs or classes. Each Participant authorizes any representative of AMB to have the Participant treated in any medical emergency during their participation in AMB activities. Further, each Participant agrees to pay all costs associated with medical care and transportation for the Participant. Each Participant has had any questions about the terms and provisions of this release answered to his or her satisfaction by the appropriate staff of AMB and has had an adequate opportunity to discuss the consequences of this release with independent legal counsel of his or her choosing.
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