Danzinskule Competition – Saturday, March 27, 2021 High School Waiver, Release & Registration Form Sponsored by – Danzinskule Education Foundation – 501c3 Non Profit

Registration is free through 2/26/21. Beginning 2/27/21, there will be a late fee of $10 per entry.

Admission tickets (separate from registration) for dancers and spectators will be $7.

All parents & students must complete this form to allow the dancer to participate in a High School single dance event:

- Samba (Level 1)
- Quickstep (Level 1)
- Waltz (Level 2)
- Paso (Level 2)

The Danzinskule competition will be held Saturday, March 27, 2021 at American Heritage School.

These High School single dance events will be held sometime between mid-morning and afternoon. Once all registrations have been received, the schedule will become finalized. Once the schedule is set, we will contact you with information to purchase tickets.

I am a*

Your School*

Student Name*

First Last

Parent Name*

First Last

Student Email*

Parent Email*

Student Phone*

(Required for potential COVID-19 contact tracing)

Parent Phone*

(Required for potential COVID-19 contact tracing)

Dancing Event*

Which event are you dancing?
(Please submit a separate registration for each event danced)

Partner*

What is your partner's name for this dance?
.

COVID-19 Waiver

As a teacher, you agree to verify your students' waiver and release agreement.*

I have a record of my students' agreement to the COVID waiver and media release

By checking the boxes below, we agree to the following COVID-19 Waiver:*

We understand that safety precautions such as required mask wearing, social distancing measures, and sanitizing procedures will be followed before event and between sessions.
We agree not to attend the Danzinskule competition if we are experiencing any symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell within 14 days of the event or on the day of the event.
We acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that the student and spectators may be exposed to or infected by COVID-19 by attending this event and that such exposure or infection may result in personal injury, illness, permanent disability, and death.
We voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to the student or spectators (including, but not limited to, personal injury, disability or death) illness, damage, loss, claim, liability, expense, of any kind, that I or the student may experience or incur in connection with the student’s attendance at the event (“Claims”).
On my behalf, and on behalf of the student, we hereby release, covenant not to sue, discharge, or hold harmless American Heritage School or dănzinsküle Education Foundation, it’s employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs of expenses of any kind arising out of or relating thereto.
We understand and agree that this release includes any Claims based on the actions, omissions, or negligence of American Heritage School and the dănzinsküle Education Foundation competition, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during or after participation in any dănzinsküle Education Foundation competition.
We understand that this release discharges dănzinsküle Education Foundation or American Heritage from any liability or claim that we, our heirs, or any personal representatives may have against dănzinsküle Education Foundation or American Heritage by attending the Danzinskule competition.
We agree that by attending the Danzinskule competition, myself and the student do so by our own choice and our own risk.

Media Release

By checking the box below, we agree to the following Media Release:*

In the process of producing educational and promotional materials, we at dănzinsküle Education Foundation may require the use of video, live streaming, still image, and voice recordings of individuals involved in the production thereof. By signing this document, we grant dănzinsküle Education Foundation all rights to the dancer's likenesses, images, and recordings, including edited versions without payment of fees in perpetuity. We authorize the use of these media for any use deemed necessary for the proper function of dănzinsküle. The aforementioned media will be used solely for dănzinsküle productions and will not be shared with any other entity.

Electronic Signature

By signing below, we agree to all conditions of this waiver and release form.

Student*

Date*

Parent*

Date*

Teacher*

Date*

The Danzinskule competition will be held Saturday, March 27, 2021 at American Heritage School.

These High School single dance events will be held sometime between mid-morning and afternoon. Once all registrations have been received, the schedule will become finalized. Once the schedule is set, we will contact you with information to purchase tickets.

COVID-19 Waiver

Media Release

Electronic Signature

Title