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I, the undersigned, certify that I am the parent and/or guardian of the minor child above and grant permission for the child to participate in the dance/cheerleading classes held by Twinkle Toes Dance Productions, L.L.C.  I warrant that the child is physically able to participate in such activities.  I recognize the risks of injury in participating in such physical activities, and I allow the child to participate in said activities and am doing so at my/the child’s sole risk.  On behalf of myself and/or the child, I agree to hold harmless Twinkle Toes Dance Productions, L.L.C., its instructors, owners, officers, employees and/or agents, from any injuries or illness that may result from, directly or indirectly, said child’s participation. 

I hereby freely and voluntarily release, discharge, waive and relinquish, on behalf of myself, the child and/or any other person claiming on my/the child’s behalf, any and all claims, actions or causes of action whatsoever, including acts of negligence, whether occurring in the studio or away from the studio premises, and for whatever period said activities may continue, for personal injury, property damage, costs, liabilities or expenses (including attorney’s fees and court costs) against Twinkle Toes Dance Productions, L.L.C., its instructors, owners, officers, employees, agents, affiliated entities and assigns acting on their behalf, and/or entities affiliated with Twinkle Toes Dance Productions, L.L.C., arising directly or indirectly from my child’s participation in any such aforementioned activities. 

I further expressly agree that in the event that any portion of this Release shall be deemed unenforceable in a Court of law, in no event shall the liability to Twinkle Toes Dance Productions, L.L.C., exceed the amount of fees collected for the instruction provided to the child. I also authorize any representative of Twinkle Toes Dance Productions, L.L.C. to obtain for my child any emergency medical treatment they deem necessary. 

As the parent/guardian, I further agree that any medical attention obtained is done at my expense, and agree to reimburse Twinkle Toes Dance Productions, L.L.C. for any emergency medical costs incurred on my child’s behalf. I also hereby authorize and consent to the use of his/her visual image by Twinkle Toes Dance Productions, LLC. for appropriate purposes, including but not limited to: still photography, electronic and print publications and websites. I give this consent with no claim for payment.

I have read, understand, and will abide by the payment policy and photo release.