BIRTHDAY ATTENDEE FORM

Parent Name *

First Name

Last Name

Dancer Name *

First Name

Last Name

Phone *

If there is an emergency, we will use this contact number

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Does The DanceRoom have your permission to take and publish photographs or videos of your child for web and social media purposes? *

Yes

No

LIABILITY WAIVER "I do hereby fully release and discharge the Host Studio, its officers, agents, servants and employees from any and all claims from injuries, damage or loss which I (or dependants under 18 years of age) may have or which may accrue to me (or dependants) on account of my (their) participation in any activities. I further agree to indemnify and defend the Host Studio, its officers, agents, servants and employees from any and all claims resulting from injuries, damages and losses sustained by me (or dependants under 18 years of age) and arising out of, connected with, or in any way associated with any activities."

I, the parent/guardian, agree to the terms of the waiver above