Parent Name *

First Name

Last Name

Students Name *

First Name

Last Name

Phone

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Legal Release of Liability: *

IN CONSIDERATION of being given the opportunity to participate in Dance Instruction or activities coordinated, taught or hosted by Little Mozarts Performing Arts Primary School INC. (Vaganova Academy of Brownsville), I, for myself, my personal representatives, assigns, heirs, and next of kin agree as follows: ACKNOWLEDGE, agree and represent that understand the nature of Dance Instruction activities, and that I am qualified, in good health, and in proper physical condition to participate in such activity. I additionally ACKNOWLEDGE that the classes that I enroll in will be taught via video conference however a representative that company will be onsite. I AGREE that my PARENT/GUARDIAN is required to be onsite during the entire lesson/instruction taught via video conference. FULLY UNDERSTAND that Dance Instruction activities INVOLVES RISKS AND DANGERS of bodily injury; these risks and dangers may be caused by my own actions, or inactions, the actions or inactions of other participants in the activity. AGREE AND WARRANT that I will examine and inspect each activity in which I take part as a participant of the dance instruction and that, if I observe any condition which I consider to be unacceptably hazardous or dangerous, I will notify the proper authority in charge of the activity and will refuse to take part int the activity until the condition has been corrected to my satisfaction. HEREBY RELEASE, discharge, and covenant not to sue Little Mozarts Performing Arts Primary School INC. (Vaganova Academy of Brownsville), or any other employee, agent, private contractor, volunteer, director, sponsor, or advertiser from all liability, claims, demands, losses or damages on my account caused or alleged to be caused in whole or in part by the negligence of the releasee or otherwise; and I further agree that if, despite this release and waiver of liability, assumption of the risk, and indemnity agreement, I, or anyone on my behalf, makes a claim against any of the releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the releasees from and litigation expenses, attorneys fees, loss, liability, damage, or cost which any may incur as a result of such claim, to the fullest extent permitted by law. I have read this agreement, fully and understand its terms, understand that I have given up substantial rights by signing it and have signed it freely and without and inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of the agreement is held to be invalid, the balance, notwithstanding, shark continue in full force and effect.