Medical, Transportation, Financial, & Social Media Release Forms

Medical Release

I authorize that, in the event of a medical emergency during Inspiration Dance Company activities, I may be

admitted to any hospital or medical facility for diagnosis and treatment. I hereby authorize physicians, dentists,

and medical staff, duly licensed as Doctors of Medicine or Dentistry, or other licensed technicians or nurses, to

perform any life-saving diagnostic procedures, treatment procedures, operative procedures, and x-ray

treatments deemed necessary for my care. No vaccines may be administered without my prior written consent.

• (Participation requires agreement to all releases, If you do not agree, you may choose not to teach, or dance.

Checking “I Agree” confirms your voluntary consent.)

Waiver, Indemnity & Assumption of Risk Agreement

In consideration of Inspiration Dance Company (hereinafter “Dance”), affiliated with Inspiration Academy (hereinafter

“Academy”) permitting myself to participate in physical activities including but not limited to exercise, competitive

sports/dance, recreational sports/dance, stretching, fitness training, conditioning and nutritional instruction (collectively

referred to as “Classes/Lessons/Competitions”), on behalf of myself, my heirs, personal representatives, or assigns, I

assume all risks and hereby release, waive, discharge, and covenant not to sue the Inspiration Dance Company or

Inspiration Academy, its employees, volunteers, agents and contractors, from liability from any and all claims arising

from or relating to my personal participation in the Dance classes/lessons/Competitions. I understand that the

DANCE/ACADEMY services are not a substitute for professional medical advice or a medical examination. Prior to

permitting myself to participate or teach any DANCE/ACADEMY program, activity, or exercise, I will seek the advice of

a pediatrician or another health-care professional. I understand that exercise and physical activity provides certain health

benefits, but can also cause unknown health issues and therefore should be done in moderation. I understand that

equipment commonly associated with physical fitness/dance may be present at the site where the classes/lessons take

place, and that the presence of such equipment could result in an injury to myself. By allowing myself to participate in the

classes/lessons/competitions or any activity associated with the DANCE/ACADEMY, I agree that the

DANCE/ACADEMY shall not be liable for any direct, indirect, special, consequential, or exemplary damages for any

injury or harm to me or incurred in or around the property where exercise occurs. I agree to hold harmless and indemnify

the DANCE/ACADEMY, its employees, volunteers, agents, contractors and insurance carriers from all claims (whether

initiated by me or by a third party) and to reimburse them for any expenses incurred because of my participation in the

classes/lessons and other DANCE/ACADEMY activities. I further agree to pay all expenses, including court costs and

attorneys’ fees, incurred by the DANCE/ACADEMY and the parties in investigating and defending a claim or suit

resulting from my participation in DANCE/ACADEMY classes/lessons/competitions. I further expressly agree that the

foregoing waiver, indemnity and assumption of risk agreement is intended to be as broad and inclusive as is permitted by

the laws of Florida, and that if any portion thereof is held invalid, it is agreed that the balance shall continue in full legal

force and effect. I also agree that if legal action is brought, it must be brought in Manatee County, Florida. I have read and

agree to the terms of the policy.

Transportation Release

I hereby give Inspiration Dance Company permission to transport the participant, myself, to any event, activity, or

competition coordinated by Inspiration Dance Company and its affiliated parties/employees.

Financial Responsibility Form

I hereby acknowledge that Inspiration Dance Company/Inspiration Academy is not required to refund any

payments for any circumstance pertaining to classes/lessons/competitions. If a refund is approved, it is case by case

and only decided by Inspiration Dance Company.

Social Media Release Form

I consent for photographs and/or video images to be taken of me by INSPIRATION DANCE COMPANY, or a

representative. I understand the images may be used for marketing purposes (website, print, digital or

social media).

By consenting to photographs and/or video images I understand I will not be compensated from

any party. Although photographs and/or video images will be used without identifying

information such as name, I understand it is possible someone may recognize me.

I acknowledge that Inspiration Academy is affiliated/connected to Inspiration Dance Company. Some

video/images may be used by Inspiration academy via website, print, digital, social media, marketing and

advertising purposes. I further acknowledge that my participation is voluntary and agree that use of any

photographs and/or video images confers no rights of ownership or royalties whatsoever.

I hereby release INSPIRATION DANCE COMPANY/INSPIRATION ACADEMY, its employees, and any third

parties involved in the creation of or publication of educational or marketing materials, from liability for any

claims by me or any third party in connection with my participation.

By typing or signing my name below, I consent to using an electronic signature, which has the same legal effect

as a handwritten signature. I confirm understanding of all forms. If I wish to withdraw my consent for any of the

following forms; Medical Liability, Transportation, Financial, and/or Social Media, I may do so via written

request submitted to INSPIRATION DANCE COMPANY or by completion of a new form. This consent form

remains valid for the duration of the student’s enrollment unless withdrawn in writing.