Participant Name *

First Name

Last Name

Participant DOB *

MM

DD

YYYY

What time should we expect you? *

Event hours are 4:30-7:30pm. Please be punctual.

Hour

Minute

Second

AM PM

Is your child toilet trained? *

Yes

No

Parent/Guardian Name *

First Name

Last Name

Phone *

(###)

###

####

Liability Waiver & Consent *

I, the parent or guardian, understand & agree that in participating in any dance class or other event there is a possibility of physical injury. I voluntarily agree, therefore, to assume all risks & responsibility for any such injury or accident which might occur to me/my child during any of the activities provided by MAGIC Dance Arts, Inc. I also exempt, release, & indemnify MAGIC Dance Arts, Inc. from any & all liability claims, demands, or causes of action whatsoever from any damage, loss, or injury to me, my child, or property which may arise out of or in connection with participation in any activities conducted by MAGIC. I understand that I should be aware of my/my child’s physical limitations & agree not to exceed them. By agreeing to the terms and conditions, I hereby consent to MAGIC Dance Arts Inc. using and publishing the information provided including photographs, statements, videos and any other non-identifying information I have given to MAGIC Dance Arts, Inc. I release MAGIC Dance Arts, Inc. from all liability and any claims I may have arising from the use and publication of this material.

I have read and agree to the terms above