RELEASE OF LIABILITY FOR PARTICIPANTS
IN CONSIDERATION OF myself or, in the case of a minor child, my child being allowed to participate in any way in Southold Dance Theater related classes,
performances, and activities (the "Program"), the undersigned acknowledges, appreciates, and agrees that:
The risks of injury and illness, including communicable diseases such as MRSA, influenza, and COVID-19, to myself or
my child from the activities involved in this Program are significant, including the potential for permanent disability and
death, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and
illness do exist; and,
1. FOR MYSELF, SPOUSE, CHILDREN, AND ALL OTHER DEPENDANTS, I KNOWINGLY AND FREELY ASSUME
ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES
or others, and assume full responsibility for myself and my child's participation; and,
2. I willingly agree to comply with the program's stated and customary terms and conditions for participation. If I observe
any unusual significant concern in myself or my child's health or readiness for participation in the Program itself, I will
remove myself or my child from participation and bring such attention of the nearest official immediately; and,
3. I myself, my spouse, my children, and all other dependants, and on behalf of my/our heirs, assigns, personal
representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Southold Dance Theater its directors,
officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if
applicable, owners and lessors of premises used to conduct the event ("Releasees"), WITH RESPECT TO ANY AND
ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property incident to myself or my
child's involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE
RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
4. I, for myself, my spouse, my children, and all other dependants, and on behalf of my/our heirs, assigns, personal
representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and
all liabilities incident to my and my child's involvement or participation in the Program, EVEN IF ARISING FROM
THEIR NEGLIGENCE, to the fullest extent permitted by law.
5. I assert that I am aware of, and if the parent/guardian assert that I have explained to my child: the risks of the activity, my
and my child's responsibilities for adhering to the rules and regulations, and that myself and my child understand this
agreement.
I, FOR MYSELF, MY SPOUSE, CHILD, AND ALL OTHER DEPENDANTS, HAVE READ THIS RELEASE OF
LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS,
UNDERSTAND THAT WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT
FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

I understand that the art of dance and the nature of dance instruction may sometimes require a teacher to touch / correct my child / me. I also understand that this will happen in a caring, gentle, and appropriate manner.

I further acknowledge that training and performing dance is a potentially hazardous activity. I also understand that such activity involves risk of injury and that I am voluntarily participating or voluntarily enrolling my child with the knowledge of the dangers involved. I hereby agree to expressly assume and accept full responsibility for the risks of bodily injury which may be sustained while participating in any activity with Southold Dance Theater.

I also agree that I have read and fully understand the current SDT Guidelines and Policies and that if I choose to participate or to allow my child to participate in any of Southold's activities, such policies would be fully respected.

IN CONSIDERATION for dance instruction or participation in Southold Dance Theater's classes and performances by my child, I release Southold Dance Theater, Inc. the dance faculty, their agents, designees, Board of Directors, or assigns, from any liability related directly or indirectly to my child's participation in any and all events either conducted by or sponsored by Southold Dance Theater, Inc. or its faculty, agents, designees, Board of Directors, or assigns.

I hereby state that I am the parent or legal guardian of the minor child whose name appears above, and herby authorize, in case of emergency, any member of the Southold Dance Theater faculty, or their agents, or designees, to consent to any necessary examination, anesthetic, medical diagnosis, surgery, or treatment, and/or hospital care to be rendered to the below-named minor under the general or special supervision and on the advice of any physician licensed to practice medicine in the State of Indiana.

I hereby state that I am the parent or legal guardian of the minor child whose name appears above, and herby grant to Southold Dance Theater, its employees, agents, and assignees, the right and permission to take photos, videos and/or films of me, my son or daughter and consent to use such materials for promotional purposes by Southold Dance Theater. I waive any right to inspect or approve either the finished photograph or the printed matter with which it may be used in conjunction.

By registering at Southold Dance Theater, I agree to follow the studio policies as stated on the Southold website, and enforce the policies with my student. I understand that these policies can change at any time. I will inquire with the administrative staff if I have any questions about the policies.