​Participant Application

Haley’s Playground Inc. & Stephanie's Dance Academy, & St. Paul Lutheran Church

Waiver and Release of Claims and Assumption of Risk

Please read this form carefully and be aware that in signing up and participating in this program/activity, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this program/activity (including transportation services, when provided).

I recognize and acknowledge that there are certain risks of physical injury to participants in this program, and I voluntarily agree to assume the full risk of any injuries, damages or loss, including eye glasses and contact lenses, regardless of severity that my minor child/ward or I may sustain as a result of participating in any and all activities connected with or associated with this program/activity. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in this program/activity against Haley’s Playground Inc. & Stephanie's Academy of Dance & St. Paul Lutheran Church including its officials, agents, volunteers and employees.


I do hereby fully release and forever discharge Haley’s Playground Inc. & Stephanie's Academy of Dance & St. Paul Lutheran Church from any and all claims for injuries, damages or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with this program/activity.

I have read and fully understand the above important information, warning of risk, assumption of risk and waiver and release of all claims.

**PARTICIPATION WILL BE DENIED-If the signature of adult participant or parent/guardian and date are not on this waiver.**

Waiver and Release of Claims and Assumption of Risk