I am the parent/guardian of the dancer(s) listed on this page, a minor, who is enrolled as a student in a course of instruction in dance with the studio of Nicole R. Swope, t/a CENTRE DANCE, of State College, Pennsylvania. By enrolling the minor in his course I certify that I am aware of the possibility of injury in connection with the activities connected therewith. I understand and agree that neither the owners, operators, agents or instructors, including but not limited to Nicole R. Swope, may be held liable in any way for any occurrence in connection with the dance studio which may result in injury or other damages to the minor, me or the minor's family heirs or assigns.
In consideration of the minor being allowed to enroll in this course, I hereby personally assume all risks in connection with the course, and I further release the instructors, program agents, and operators, including but not limited to the persons mentioned, of any injury or damage which may befall the minor while the minor is enrolled as a student of the school, including all risks connected therewith, whether foreseen or unforeseen; and further, to save and hold harmless the program and persons from any claim by or on behalf of the minor or the minor's family, estate heirs or assigns, arising out of the minor's enrollment and participation in the course.
I further state that I am of lawful age and legally competent to sign this affirmation and release that I understand the terms herein are contractual and not mere recital; and that I have signed this document as my free act.
I have fully informed myself of the content of this affirmation and release by reading it before I signed it electronically.