Dancer's Name *

First Name

Last Name

Date

MM

DD

YYYY

Liability Release Agreement

As the participant, legal parent, or guardian, I release and hold harmless Borne Arts Collective, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Borne Arts Collective, its owners and operators or in route to or from any of said premises. I hereby voluntarily and without compensation authorize pictures, images, video, the use of my likeness, and/or voice recording(s) to be made of me (or of the above-name individual if the individual is legally unable to give consent) by Borne Arts Collective, while I or the student enrolled are taking classes, performing, dancing, or participating in any activity related to dance and performing, with Borne Arts Collective. I understand that the said picture, image, video and/or voice recording is intended for the following purpose(s): Promote dance classes, social media post promoting dance, classes, performances, a healthy lifestyle, use on our website (www.mydance10.com) for illustrative purposes, and any and all marketing materials designed to promote shows, performances, and dance classes related to Borne Arts Collective and their students.

I've read the above and agree