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Release of Liability and Policies form

4000 Middlefield Road, Studio L3

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Palo Alto

Assumption of Risk and Waiver of Liability

1. I understand that participation in dance classes, rehearsals, and performances involves physical activity and the risk of injury, included but not limited to sprains, strains, falls, and other physical harm. I acknowledge that VickyDanceVisions Studio take reasonable steps to ensure safety but cannot eliminate all risks. Additionally, Virginia Brey (Vicky Brey) and DanceVisions are NOT LIABLE for loss or damage of personal property or personal injury. The consumer/client assumes ALL RISKS of personal injury connected to physical activity, while, on or about Cubberley Dance studio(s) premises, including, but not limited to dancing and receiving dance or ballet instructions. Virginia Brey, sole proprietor of VickyDanceVisions at DanceVisions is NOT LIABLE for any claim, demand, cause of action of any kind whatsoever for (including Pandemic related claims),or on account of death, personal injury, property damage or loss of any kind, resulting from or related to costumer or client’s use of facilities (client being any class participant or legal guardian) or participation in activity within or without the premises. Please inform Virginia Brey of any physical limitations you may have. If you are in doubt as to your physical abilities, please consult your physician before enrolling or participating in any dance class. 

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By signing below I voluntarily assume such risks and agree to release and hold harmless VickyDanceVisions and its owner Virginia Brey, instructors, volunteers, employees and affiliates from any and all liability, claims or demands arising from my child participation in studio activities.

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3. Illness Acknowledgement

2. I acknowledge that exposure to contagious illnesses, including COVID-19 is a risk in any group setting. I agree not to send my child to class if they are showing signs of illness. I understand that VickyDanceVisions follows recommended health guidelines but cannot guarantee a virus-free environment.

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I accept the risk of illness transmission and waive any liability claims against the studio related to COVID-19 or similar conditions.

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4. Emergencu Medical Authorization

In the event of an emergency, I authorize VickyDanceVisions and its representatives to obtain and approve emergency medical care for my child. I understand that every effort will be made to contact me first. I accept responsibility for any resulting medical expenses.

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5. Photo and Video Release

I grant permission to Vicky DanceVisions and its representatives to take photographs and video footage of my child during classes, rehearsals, and performances. These may be used for promotional, social media, or training purposes, without compensation

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Check here if you do not consent ____

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5. Agreement and Signature

I certify that I am a parent or legal guardian of the participant named above and that I have read and fully understand this waiver. I agree to its terms on behalf of my child and acknowledge that my signature on this document is legally binding.

NOTICE: Tuition and Payment Policies are on the website at vickydancevisions.com

By signing below, the participant or parent/legal guardian agrees to the payment policies and attendance policies written on the website vickydancevisions.com

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Enrollment is from September 8th   2025 to May 30th 2026. Participants may withdraw completely anytime, but a 2 week notice in advance is kindly requested. Tuition will be paid monthly on the 1st of each month according to the fixed fees established by VickyDanceVisions.

Thanks for submitting!

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