Valentines Parents Night Out

Medical Release:

This is to certify that the above DANCER has permission to participate in all things sponsored by Urban Dance Empire, LLC (hereafter known as “UDE”). I hereby release UDE, the Business, its owners, directors, faculty, assistants, and volunteers from any liability for injuries and all liability including loss, damage, or injury including death that may be sustained by the participant while upon the premises or any premises under the control and supervision of UDE and its agents. I fully understand the risks involved in dance class including performances, rehearsals, competitions, workshops, and/or the activities above DANCER is registered for in which may or may not be located on UDE property. I accept such, unconditionally, and take full responsibility for all accidents and/or injuries, which may occur as a result of my child(ren)s participation at UDE. I understand the risks involved with physical participation in any above activities with illness such as, but not limited to influenza, MRSA, or related strands to Covid and will take personal responsible for precautions and safety.

I fully understand that UDE and its agents are not physicians or medical practitioners of any kind. I hereby release UDE to render temporary first aid to my child(ren), in the event of any injury or illness and if deemed necessary to call and seek medical help, including transportation by a UDE staff member or its representatives, whether paid or volunteer, to any health care facility or hospital, or the calling of an ambulance for said child(ren) should UDE staff deem this to be necessary and I give my consent for any and all medical treatment.

 

Media Acknowledgement:

I acknowledge that above DANCER may be videotaped, photographed, and/or viewed during online classes while involved with UDE and could be used for promotional videos and/or pictures to include, but not limited to brochures, posters, social media and promotional videos for display, distribution, publication, and/or transmission.