AFRO-TEMPO WAIVER FORM
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Thank you for registering for an Afro-Tempo Workshop!
Filling out this waiver form is MANDATORY. Please complete before attending and participating in ANY Afro-Tempo Workshop activity.
What date are you attending an Afro-Tempo Dance Workshop? *
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I acknowledge my awareness and participation of my physical activities with Light So Shine Dance Company. *
Required
I understand that my participation in the aforementioned dance and exercise activities may expose me to certain foreseeable and unforeseeable risks of damage and/or bodily injury, including serious bodily injury, where I may need to be hospitalized. *
Required
I knowingly, freely and voluntarily assume all risks and engage myself in the participation of the mentioned ‘Afro-Tempo Dance Workshop with Liz’ activities. *
Required
I hereby release Light So Shine Dance Company from any and all liability arising out my participation of the mentioned activities and hereby waive my rights herein to assert any claim(s) for damages, bodily injury or serious bodily injury to the fullest extend allowed by law. *
Required
I further agree that I will hold harmless Light So Shine Dance Company against any and all claim(s) for damages, bodily injury or serious bodily injury arising out of or in connection of my participation in the above mentioned ‘Afro-Tempo Dance Workshop with Liz’ activities whether caused by negligence or otherwise. *
Required
I grant to Light So Shine Dance Company, its representatives and employees the right to take photographs of me and my property in connection with the Light So Shine Dance Company at the event, ‘Afro-Tempo Dance Workshop with Liz’.  I authorize Light So Shine Dance Company its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Light So Shine Dance Company may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. *
Required
I fully understand the terms set forth in this form, and I hereby execute this Physical Activity Release of Liability Form and Photo Release form. *
Required
Typing your full name indicates an Electronic Signature.
Participant's Full Name: *
If Under 18
If you are under 18, your Parent/Guardian must type their name in this form which will indicate an Electronic Signature.
Parent/Guardian's Full Name
Thank you! See you at the Workshop!
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