Insurance Release and Photo Permission Forms
Insurance Release
I certify that my child *	is in proper physical condition to take part in dance class. I realize that there are certain risks possible in the art of dancing. I agree to assume the risk of all injuries or damage that may arise from my child's participation in the dance classes at The NY Dancers Studio. In consideration of the above, I hereby release and hold harmless The NY Dancers Studio, it's teachers and Director from and against any liability or claim for any loss of property, injury, misadventure, harm, cost of damage sustained as a result of my child's participation in classes at The NY Dancers Studio.
I have read this release and understand its meaning *	Note this is your electronic signature. By signing your name here you understand and agree to the above release.
Medical Information: *	If your child has any medical conditions that you feel his/her teacher should be aware of, please list them here.
Emergency Contact:
Name *
Phone Number *	### - ### - ####
Alternate Phone Number	### - ### - ####
Photo Permission Slip During classes and performances photos and videos will be taken. We would like to share some of these shots through our website, facebook, advertisements and in the studio. If you wish to change your permission at any time, please contact The NY Dancers Studio in writing.
Please indicate your preference below and return this form to the dance studio *	I GRANT permission for my child’s photos to be displayed at The NY Dancers Studio and through their media outlets.    I DO NOT GRANT permission for my child’s photos to be displayed at The NY Dancers Studio and through their media outlets.   Please note: Dancer’s names will not be used or released
Dancer's Name *
Prefix
First *
Last *
Suffix
Parent's Name *
Prefix
First *
Last *
Suffix
Signature *	Note this is your electronic signature. By signing your name here you understand and agree to the above information.
Date *	MM / DD / YYYY