Loading...

REVIVE DANCE CONVENTION

IN-PERSON:

I, the individual identified below (“Participant”), acknowledge that I am voluntarily agreeing to participate in the following dance or athletic activity (“Activity”) that is being sponsored by Revive Dance Convention (“Revive”). 

I understand and agree that regardless of the care that I may take to avoid risks, my participation in the Activity has inherent risks, whether the risk is the result of: (a) pandemic, epidemic, or other infectious disease; or (b) the fact that the Activity will require strenuous physical activity that may involve health risks including but not limited to serious injury, bodily harm, or death. I am also aware that while risks may be increased by any physical conditions that could be more serious due to physical exertion, including, but not limited to neck, back, heart problems and pregnancy (“Adverse Condition”); (c) human error; or (d) equipment problems; or (e) other unforeseen circumstances, events of occurrences. I represent and warrant to Adrenaline that I am aware of the foregoing risks, and that I freely elect to participate in the Activity. In addition, I represent to Adrenaline that, to the best of my knowledge, I am in good health and not suffering from any Adverse Condition. I acknowledge that Revive has not made any representations to me about my ability or to participate in the Activity. Because my participation in the Activity is voluntary, I knowingly and voluntarily assume any and all risks or any kind that may arise as a result of my participation in the Activity. 

I specifically release and agree to indemnify and hold Revive harmless from any claims, causes of action, suits, costs, expenses, and damages as a result of my participation in the Activity. 

I agree that this Waiver is intended to be as broad and inclusive as possible under law. 

By signing below, I hereby give Revive its instructors, directors, contractors, and event venue the right to use my image of the registered parties for promotional and advertising purposes, on the social media platforms, website and brochures of Revive.

I understand that if the particiapant leaves the workshop ballrooom at any time (to use the restroom or other purposes), Adrenaline Dance will not chaperone or monitor them upon leaving the workshop ballroom.

In the event of emergency, I authorize Revive (and/or its agents, employees, representatives, or instructors) to act exercise its best judgment in seeking medical attention for Participant.

If this Waiver is being signed by a parent or guardian on behalf of a minor, the parent or guardian agrees the terms of this Waiver apply to and are binding on the parent or guardian. 

I have read and understand the foregoing Waiver, understand I am giving up substantial rights, and am signing this Waiver freely and voluntarily. This Waiver is valid for all activities of Revive for a period of one year after the date set forth below.

I, the individual identified below (“Participant”), acknowledge that I am voluntarily agreeing to participate in the following online dance or athletic activity (“Virtual Activity”) that is being sponsored by Revive Dance Convention (“Revive”).

I understand and agree that regardless of the care that I may take to avoid risks, my participation in the Virtual Activity has inherent risks, whether the risk is the result of: (a) pandemic, epidemic, or other infectious disease; or (b) the fact that the Virtual Activity will require strenuous physical activity that may involve health risks including but not limited to serious injury, bodily harm, or death. I am also aware that while risks may be increased by any physical conditions that could be more serious due to physical exertion, including, but not limited to neck, back, heart problems and pregnancy (“Adverse Condition”); (c) human error; or (d) equipment problems; or (e) other unforeseen circumstances, events of occurrences.\

I represent and warrant to Revive that I am aware of the foregoing risks, and that I freely elect to participate in the Virtual Activity. In addition, I represent to Revive that, to the best of my knowledge, I am in good health and not suffering from any Adverse Condition. I acknowledge that Revive has not made any representations to me about my ability or to participate in the Virtual Activity. Because my participation in the Virtual Activity is voluntary, I knowingly and voluntarily assume any and all risks or any kind that may arise as a result of my participation in the Virtual Activity.

I specifically release and agree to indemnify and hold Revive harmless from any claims, causes of action, suits, costs, expenses, and damages as a result of my participation in the Virtual Activity. 

I agree that this Waiver is intended to be as broad and inclusive as possible under law. 

By signing below, I hereby give Revive its instructors, directors, contractors, and event venue the right to use my image of the registered parties for promotional and advertising purposes, on the social media platforms, website and brochures of Revive.

If this Waiver is being signed by a parent or guardian on behalf of a minor, the parent or guardian agrees the terms of this Waiver apply to and are binding on the parent or guardian. 

I have read and understand the foregoing Waiver, understand I am giving up substantial rights, and am signing this Waiver freely and voluntarily. This Waiver is valid for all activities of Revive for a period of one year after the date set forth below.

Printed Name of Participant:   _______________________

Birth Date of Participant:         _______________________

Signature of Participant

(or Parent/Guardian if Participant is under 18 Years of Age): ____________________________

Date Signed: 

 

VIRTUAL:

I, the individual identified below (“Participant”), acknowledge that I am voluntarily agreeing to participate in the following online dance or athletic activity (“Virtual Activity”) that is being sponsored by Revive Dance Convention (“Revive”).

I understand and agree that regardless of the care that I may take to avoid risks, my participation in the Virtual Activity has inherent risks, whether the risk is the result of: (a) pandemic, epidemic, or other infectious disease; or (b) the fact that the Virtual Activity will require strenuous physical activity that may involve health risks including but not limited to serious injury, bodily harm, or death. I am also aware that while risks may be increased by any physical conditions that could be more serious due to physical exertion, including, but not limited to neck, back, heart problems and pregnancy (“Adverse Condition”); (c) human error; or (d) equipment problems; or (e) other unforeseen circumstances, events of occurrences.

I represent and warrant to Revive that I am aware of the foregoing risks, and that I freely elect to participate in the Virtual Activity. In addition, I represent to Revive that, to the best of my knowledge, I am in good health and not suffering from any Adverse Condition. I acknowledge that Revive has not made any representations to me about my ability or to participate in the Virtual Activity. Because my participation in the Virtual Activity is voluntary, I knowingly and voluntarily assume any and all risks or any kind that may arise as a result of my participation in the Virtual Activity.

I specifically release and agree to indemnify and hold Revive harmless from any claims, causes of action, suits, costs, expenses, and damages as a result of my participation in the Virtual Activity. 

I agree that this Waiver is intended to be as broad and inclusive as possible under law. 

By signing below, I hereby give Revive its instructors, directors, contractors, and event venue the right to use my image of the registered parties for promotional and advertising purposes, on the social media platforms, website and brochures of Revive.

If this Waiver is being signed by a parent or guardian on behalf of a minor, the parent or guardian agrees the terms of this Waiver apply to and are binding on the parent or guardian. 

I have read and understand the foregoing Waiver, understand I am giving up substantial rights, and am signing this Waiver freely and voluntarily. This Waiver is valid for all activities of Revive for a period of one year after the date set forth below.

Printed Name of Participant:   _______________________

Birth Date of Participant:         _______________________

Signature of Participant

(or Parent/Guardian if Participant is under 18 Years of Age): ____________________________

Date Signed: 

Please select who will be participating...
AdultMinor
Continue
First Dancer Name

First Name*

Last Name*

Phone*
First Dancer Age Acknowledgment*
First Dancer Date of Birth*
I certify that I am 18 years of age or older
First Dancer DANCER Information

Full Studio Name *
First Dancer Signature*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's DANCER Information

Full Studio Name *
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!