Audition registration form

Please complete the form below

Name

First Name

Last Name

Participant's Birthdate

YYYY

Participants Email

Participant's Phone Number

Number of years dancing

Current School

Parent/Guardian's Name (if under 18) or Emergency Contact (if 18 or older)

First Name

Last Name

Parent/Guardian/Emergency Contact - Email

Parent/Guardian/Emergency Contact - Phone Number

Audition Options

August 21, 2017 | Ages 12+, 4:30-6:30PM in Studio 1 at Jessie Eccles Quinney Ballet Centre Downtown Campus

Aug. 22, 2017 | Ages 7-12, 4:30-6:00PM at Trolley Square

Waiver and Typed Signature

BALLET WEST ACADEMY ASSUMPTION OF RISK, WAIVER OF LIABILITY AND INDEMNIFICATION AGREEMENT IMPORTANT: THIS IS A LEGAL DOCUMENT, PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING. This Agreement must be completed in order to participate in activities associated with Ballet West Academy/Ballet West. As legal the guardian of my designated minor participant(s) or the adult participant, I confirm that I am familiar with the activities that will take place and I hereby consent to the following: TERMS AND CONDITIONS I will participate or authorize the Participant to participate in the activities at the facilities of Ballet West Academy. I understand that such participation can include foreseeable and unforeseeable risks and other hazardous activities inherent in the program, which may expose the participant to illness, injury, or death. Participant or Guardian/Parent freely and voluntarily participates or allows participation in the program with the knowledge of the danger involved and hereby agrees to assume and accept any and all risk of injury or death. PHOTOGRAPHY RELEASE Under 18 I hereby grant Ballet West permission to photograph my child and use their likeness in a photograph/image in any of its publications, including website entries, without payment or any other consideration. I understand and agree that photographs will become the property of Ballet West and be used for the purpose of publicizing Ballet West, its programs and initiatives. I waive the right to approve finished product as well as any right to royalties or other compensation related to the use of any photography. Over 18 I hereby grant Ballet West permission to photograph me and use my likeness in a photograph/image in any of its publications, including website entries, without payment or any other consideration. I understand and agree that photographs will become the property of Ballet West and be used for the purpose of publicizing Ballet West, its programs and initiatives. I waive the right to approve finished product as well as any right to royalties or other compensation related to the use of any photography. WAIVER, RELEASE AND INDEMNIFICATION Participant or Guardian/Parent of Participant understands and acknowledges that Ballet West Academy (“Academy”) and/or Ballet West ("Company") are not insurers of Participant's behavior, actions or participation in the program, and that the Academy and Company assumes no liability whatsoever for personal injuries or property damages to Participant or to third persons arising out of participation in the program activities. Participant or Guardian/Parent hereby agrees to release, waive, covenant not to sue, indemnify and hold harmless the Ballet West Academy/Ballet West, and all of their officers, employees, and agents (collectively the "Releases") from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by Participant or loss or damage to any property belonging to Participant arising out of or related to participation in the above named Program, and excepting only such loss, damage or injury as may be caused by the sole negligence of any Release. Participant or Guardian/Parent of Participant agrees that the site of any lawsuit arising out of or related to participation in the Program shall be Utah and that this Agreement will be governed by and construed in accordance with the laws of the state of Utah, without application of any principles of choice of law. Participant does not have any medical conditions that would prevent participation in course Program. Participant has adequate health insurance to cover the costs of treatment in the event of any injury. Participant shall pay any attorney fees or costs incurred by the Academy and/or Company in enforcing this Agreement. If any portion of this Agreement is held to be invalid by a court of law, then it is agreed and intended that all the remainder shall, notwithstanding, continue in full force and effect. PARTICIPANT OR GUARDIAN/PARENT OF PARTICIPANT HAS CAREFULLY READ THESE TERMS AND FULLY UNDERSTANDS THEIR CONTENT AND IS AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN PARTICIPANT OR GUARDIAN/PARENT OF PARTICIPANT AND THE RELEASES AND SIGNS IT OF HIS OR HER OWN FREE WILL. By confirming this Agreement on behalf of myself or a minor Participant I acknowledge that I am the Guardian / Parent of the Participant and that I understand the terms of this Agreement. I also acknowledge that these terms shall bind my heirs and personal representatives and the heirs and personal representatives of Participant.