Consent & Release Form

I understand that ballroom dance is a physical activity that, as with any physical activity, includes risks or hazards of injury. Ballroom dance can be strenuous and students may suffer injuries, either minor or very serious in nature. Dance Maui will not, and does not, accept responsibility for injuries sustained by any student during the course of instruction or related activities, or in the course of any exhibition, competition, or other event in which he or she may be a participant in, or while traveling to or from any event. Acknowledging the above, I consent to my participation in the programs offered by Dance Maui. I, for myself waive and release all rights and claims for damages that I or my child may have at any time against Dance Maui including, specifically, for any injury or damages that may be suffered by me or my children in connection with my child’s participation in the activities offered and/or sponsored by Dance Maui.

I fully understand that the teacher(s) and staff of the studio are not physicians or medical practitioners of any kind. With this in mind, I hereby release Dance Maui to render temporary first aid in the event of any injury or illness and, if deemed necessary by Dance Maui or staff of the studio, to contact a doctor and to seek medical help, including transportation to any health care facility or hospital, or the calling of an ambulance or other emergency medical services. I also affirm that I now have and will continue to provide proper hospitalization, health and accident coverage which I consider adequate for my own protection. I understand that it is strongly advisable that I should have had a physical within the last year. I have no known disabilities that would prevent him or her from participating in dance class.

I do hereby authorize Terry Hans, Hawaii Latin and Ballroom Dance LLC dba Dance Maui, and those acting pursuant to their authority to: Record my participation and appearance on video, audio, film, photograph or any other medium / Use my name, likeness, voice and biographical material in connection with these recordings / Exhibit or distribute such recording in whole or in part without restrictions or limitation for any educational or promotional purpose which above stated organizations, and those acting pursuant to its authority, deem appropriate.

You may take pictures and record video during class. Please always credit Dance Maui and link/tag us

If you are bothering other students we reserve the right to ask you to leave class at our discretion. Our students safety and comfort are paramount. There will be no refund if asked to leave.