Please print and fill out the following registration form:

San Francisco Youth Ballet Academy
ADULT CLASS FORM

Name:________________________________________________________

Address:______________________________________________________

City:_____________________________________ZIP:________________

Phone:_____________________Email:____________________________

In consideration of being allowed to participate in any way in the classes, workshops, and programs or to be present in the studios, office or bathroom of San Francisco Youth Ballet Academy, I (print name) ____________________________, the undersigned, acknowledges, appreciates and agrees that:

Dance is a physical activity and I am in good physical health to participate. I assume all risks of damage and injury that I may incur due to participation; and I fully and completely RELEASE, ACQUIT AND FOREVER DISCHARGE SFYBA and its respective principals, officers, directors, agents, insurers, employees, representatives, successors and assigns from any and all claims, actions and causes of action that I may have in the future of any nature whatsoever. I agree to sole responsibility for any and all costs and expenses that I may suffer of any kind, and I will not sue or assert any such claim against SFYBA.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK
AGREEMENT, FULLY UNDERSTAND ITS’ TERMS, AND SIGN IT
FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

X________________________________________ Date _____________
Participant Signature or Guardian if Under 18
_________________________________________
Print Name