FIERCE THE ULTIMATE DANCE CONVENTION
($200 -- check made out to FIERCE CONVENTION)
DEADLINE: SEPTEMBER 5, 2011
WAIVER AND RELEASE FORM 2011
I hereby waive all claims for injury, damage or loss to my person and property during my participation and release the promoters, directors, principals, agents and employees of Fierce Productions and Convention from any liability for injury, damage or loss which may be caused by any act or omission of any of them.
I understand that the purpose of FIERCE Productions and Conventions is to provide quality danceworkshops and studio showcase dance opportunities. Photographs, taping or filming of participants by any and all FIERCE Productions and Convention Staff members, agents or members of the press become the property of FIERCE Productions and Convention and may be used for future promo use. By signing, each of the registered participants in FIERCE Productions and Convention each dancer and/or parents expressly adopts and agrees to be bound by the above Waiver and Release Agreement.
The signature of a parent/guardian, studio director/owner, or teacher is required in the case of every participant who is under 18 years of age (participants 18 years of age and over must sign for themselves).
Studio directors/owners or teachers may sign for their students.
The proper signing of this agreement on this form is a condition of participation in the event.
PLEASE FILL OUT:
Studio Name : RIMVIEW DANCE STUDIO________________
Director: MISS LYNDA KAYE MCCLEARY_________________
Address: 278 Quiet Water Avenue______________________
City/State/Zip: Billings Montana 59105___________________
Studio Phone: (406)-855-4909_________________________
DANCER'S NAME___________________________________
PARENT'S SIGNATURE______________________________
PARENT'S TELEPHONE______________________________