LIABILITY RELEASE / WAIVER FORM

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Pearl Lindsey
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1 LIABILITY RELEASE / WAIVER FORM All participants and students must complete this form before participating in any dance classes, Master class, dance workshops or rehearsals at, BALLET DE MEXICO DE AMALIA V.B. HERNANDEZ. If participant is under age 18, a parent or guardian must also sign this form. Admission to class and/or rehearsal will not be granted if this form is not received prior to class and is not properly signed. Waiver of Liability I, recognize and understand the risks of physical injury inherent to dance and dance training and I fully assume those risks. I hereby release BALLET DE MEXICO DE AMALIA V.B. HERNANDEZ its affiliates dance studios, event sponsors, employees and dance teachers from all liability for injuries sustained or illnesses contracted while attending or participating in any dance classes, rehearsals, workshops, or performances. I agree to indemnify, defend, and hold harmless BALLET DE MEXICO DE AMALIA V.B. HERNANDEZ affiliate dance studios, event sponsors, employees and dance teachers for liabilities, costs and judgments arising from acts of omissions committed by me or my child which result in injury or damage to any person or property. Initials: Protection of Property I understand and agree that it is my sole responsibility to safeguard my personal property while attending or participating in any classes, rehearsals, workshops, or performances. I hereby release BALLET DE MEXICO DE AMALIA V.B. HERNANDEZ, its affiliate dance studios, event sponsors, employees and dance teachers from all liability for loss or damage to my personal property while attending or participating in classes, rehearsals, workshops, or performances. I also agree to abide by any rules, regulations and policies set forth by BALLET DE MEXICO DE AMALIA V.B HERNANDEZ Initials: Medical Attention In case of physical injury or medical emergency, I hereby authorize BALLET DE MEXICO DE AMALIA V.B. HERNANDEZ to make necessary arrangements to transport myself or my child to a medical treatment facility as necessary. All such transportation and medical treatment will be at my sole cost and expense. In extreme emergency, or if my child is under 18 years of age, I understand that BALLET DE MEXICO DE AMALIA V.B. HERNANDEZ will attempt to notify the person(s) I have named below as my emergency contact(s) of my condition. Initials: Photo Release BALLET DE MEXICO DE AMALIA V.B. HERNANDEZ reserves the right to use photographs and videos taken during classes, workshops, performances, or other affiliated events for the purposes of instruction, advertising and promoting BALLET DE MEXICO DE AMALIA V.B. HERNANDEZ and its programs. Students, or parents of students who are minors, who do not wish to comply with this policy must notify BALLET DE MEXICO DE AMALIA V.B. HERNANDEZ prior to participation in class. PROHIBITED TO VIDEO TAPE AND TO TAKE PICTURES DURING CLASSES AND PRESENTATION AS WELL LIVE SOCIAL AND IPHONE VIDEOS. Initials: Acknowledgement of Waiver In signing this Release, I acknowledge and represent that I have fully informed myself of the content of the waiver and hold harmless agreement by reading it before I sign it, and I understand that I sign this document as my own free act and deed; no oral representations, statements, or inducements, apart from the written statement, have been made. I further state that I am at least eighteen (18) years of age and am fully competent to sign this agreement; and that I execute this release for full, adequate, and complete consideration fully intending to be bound by the same. I further state that there are no health-related reasons or problems which preclude or restrict my or my child s participation in this activity, and that I will pay any medical costs that may be attendant as a result of injury to me or my child. Initials: Signature Date 1)

2 PLEASE PRINT CLEARLY ( Black ink only) Print Name of Participant Date Signature of Participant Print Name of Parent/Guardian Date (if under 18) Signature of Parent/Guardian (if under 18) Home Address _ Phone Number Address _ Emergency Contact (if different from parent) Relationship to Participant Emergency Numbers (if different from number listed above) Please list any medical conditions, injuries, allergies, etc. BALLET DE MEXICO DE AMALIA V.B. HERNANDEZ. AUSTIN TX PH- (512) Enviar forma / Send form at ELISSA@BALLETMX.COM 2)

3 Name of student: Date Date of Birth: Birth place: Years of dance ( please answer even if some are 0 years) Classical_ Technique Name Modern Others types of dance yrs Folklore dance of other Countries yrs Country Mexican dance Folklore yrs School or Group (s) Describe your self as a dancer in two sentences. What is - are your passion (s). What is your #1 Dream Waiver has to be completed and sign at the time of registration. On the contrary dancers will not be able to participant. BALLET DE MEXICO DE AMALIA V.B. HERNANDEZ. AUSTIN TX PH- (512) Enviar formas a / Send forms at ELISSA@BALLETMX.COM 3)

4 Información Adicional 1) Dirección, Maestros Titulares, y Maestros Invitados Amalia V.B. Hernandez Directora Artística de el Ballet Folklórico de México de Amalia Hernández Fundadora y Directora Artística de el Ballet de México de Amalia V.B. Hernandez en Estados Unidos. Janelle Ayón Maestra y Ex-Bailarina del Ballet Folklórico de México de Amalia Hernández Miguel Angel Marroquín Maestro y Ex - Bailarín del Ballet Folklórico de México de Amalia Hernández. 2) El taller consistirá de los siguientes elementos Calentamiento Técnica Estilo y presencia para escenario Zapateado Faldeo Coreografías Estilo Amalia Hernández, tradicionales, fusion moderno, flamenco, Hip Hop. ( Las coreografías pueden cambiar sin previo aviso) 3) Protocolo y Uniforme Mujeres Leotardo de color ( cualquier leotardo) o indumentaria no floja! Falda con vuelo ( de folklore, cualquier color) Zapatos de folklore, Zapatillas de ballet, (opcional) Cabello en una dona ( bien peinado ( para visibilidad de cuello y espalda) Leggins de cualquier color. Hombres Camiseta cualquier color sin logotipos Botas de folklore, zapatillas de Ballet (opcional) Pants o leggins de cualquier color No se permite filmar ni tomar fotografías durante clases Queda prohibida la filmación en vivo para redes sociales solo durante classes. NO VIDEO NOR PICTURES ALLOWED AND SOCIAL MEDIA IS PROHIBITED DURING CLASSES

5 REGULAR SCHEDULE FOR A MASTER CLASS OR WORKSHOP Schedule subject to change without any further notice. Please make sure to arrive at 8:45 am be ready by 9:00 am. Class will start RIGHT on time. There will be a professional video taken during Sunday, class/ and Showcase so make sure to look professional. For ( Girls / women ) Your own dresses, accessories and Makeup required, Hair pulled up to perfection in a bun. For Boys / Men, your Costume and accessories is required Please check for State repertory presented in your Master Class at Friday *Class on Friday will start with Maestra Amalia s welcome words, (9:00 am to 9:05 am) Introduction to Maestro/a/s Titular/es (9:05 am to 9:10 am) Friday, Saturday Morning Masterclass *Master class will continue with Director and Maestra Amalia V.B. Hernandez 9:00 am to 10:30 am * Master Class will continue with Maestra Titular, and technique class and repertory 10:35 am to 12:05 pm Break 12:05 pm to 12:15 pm *Master class will continue with Maestro/a Titular Schedule subject to change without any further notice. 12:15 pm to 1:45 pm Lunch 1:45 pm to 3:15 pm Friday, Saturday Afternoon Masterclass Master class continues with Directora y Maestra Amalia V.B. Hernández Repertua 3:15 pm to 4:45 pm Master class continues with Maestro/a Titular Repertua 4:45: pm 6:15 pm BREAK 6:15 pm to 6 :30pm 1) Master Class continues with Maestro/a Titular Repertua pm to 6:30 to 8:PM pm Sunday VIDEO AND PICTURES ARE ALLOWED DURING PRESENTATION NOT CLASSES. WARM UP, and REHEARSAL #1 9 am to 10 am REHEARSAL #2 10 am to 11 am REHEARSAL #3 11am to 12pm PRESENTATION 12:30 pm to 1:30 pm CERTIFICATES 1:35 pm TO 2:00 pm PICTURES 2:00 to 2:30 END

2 Canton Street, Suite A-8 Stoughton, MA Summer Stock Registration Form

2 Canton Street, Suite A-8 Stoughton, MA 02072 781-886-6136 www.theconservatoryschool.com 2017 Summer Stock Registration Form Student Full Name Address Home Phone Emergency Contact Student DOB City/State/Zip