Release Form
Please read carefully. You will be sent, and required to sign, a physical copy of this release and return it to the Dance Palace for your child to participate.
- As parent or legal guardian, I give permission for my child to attend Virtual DPC.
- I have received and read the information and policies and understand it is my part of my registration agreement. I agree to comply with the virtual camp policies.
- I agree to release and hold harmless the Dance Palace, its employees, officers, directors, agents, and contractors from all liability for any personal injury, property damage, loss, insurance costs, and all liability incurred as a result of my child’s participation in camp. These terms serve as a release for myself and members of my family.
- I give the Dance Palace permission to use my email address as part of a group list (sent by blind copy) to receive information about camp activities and relevant information.
I understand and agree:
I retain full supervisory responsibility for any and all activities that happen as a part of Virtual DPC.
Camp staff refers to adults who have been screened, approved and trained and may be paid staff or volunteers.
- I will not expect camp staff to provide supervision for my child. I agree that there will be an adult present and available to answer at the phone number provided during Virtual DPC sessions.
- I understand that participation in these activities is at my and my child’s own risk. While measures are being taken to manage any risk, there is still the risk that something unexpected may happen. If my child gets hurt while participating in any Virtual DPC activity or activity recommended by Virtual DPC, I will assume full responsibility.
- I will maintain and supervise any online accounts that my child may participate in.
- If my child or I upload any photos or videos of my child, our family and/or their activities, I am giving permission for them to be used and shared publicly.
- I understand that my child will be participating in two-way classes and group sessions that are closed and will only allow registered participants and approved staff to participate.
- For all two-way classes, like a Zoom class, I will ensure that my child is appropriately dressed and that the computer and camera that they are using does not show inappropriate things in our home. On the screen behind my child there will be an appropriate non-descript background. If staff notice something on your child’s video that staff determines is not appropriate, they will turn off your child’s video until the issue is resolved.
- Appropriate behavior for participants will be expected. Camp staff will review appropriate and inappropriate behaviors with campers. Bullying, including cyberbullying, during a session or outside of a session will not be tolerated. Issues and consequences will be addressed with camper and parent including and not limited to temporary or permanent removal from Virtual DPC.
- I understand that my child may be in either a screenshot and/or video record. These artifacts may be used by The Dance Palace for current or future publicity and promotion. Before either a screenshot or a recording happens, participants will be notified. If I do not wish for my child to be in the picture or the recording, they should immediately turn off their camera and mic. Leaving either of those two on is implied consent. The room will be told when the recording is stopped. It is solely my responsibility to take any necessary steps to prevent my child being recorded.
I agree to follow and to ensure that my child(ren) follow the Virtual DPC Electronic Communication Policy that states:
- Any private (one to one) electronic communication between staff and youths, including the use of social networking websites like Facebook, Instagram, Snapchat, instant messaging, texting, etc is prohibited.
- All communication between staff and youths must be transparent and public.
- Communication to the child will include at least two approved adult volunteers. They may communicate in private media set up for two-way classes and discussion groups, such as a Zoom class. These will be always facilitated by at least two approved adults with at least two children and one approved adult in each breakout room. The overall facilitators may join any breakout room at any time.
- It is my responsibility to provide any equipment needed for virtual programs, such as a computer, tablet, internet access, headset, earphones, microphone, etc. I also understand that any damage to said equipment is the sole responsibility of the owner of said equipment. I will not hold The Dance Palace responsible for any damage that may happen during Virtual DPC.
Waiver and release statement:
Permissions
By registering for Virtual Dance Palace Camp, the undersigned “I” (whether one or more) jointly and severally state and agree as follows:
Consent for Minors
I am the legal custodial parent or legal guardian of the above-named minor, and I hereby authorize and permit said minor to participate in Virtual DPC and in all activities, events, and programs that are part of or are associated with the camp (collectively “Camp”). I have read material on the website about this program.
Acknowledgement and Waiver
I realize that participation in the Camp entails certain risks of personal injury and property damage. I affirm and agree that I and any above-named minor(s) are participating in the Camp voluntarily and knowingly assume all such risks. In consideration of me and/or any above-named minor(s) being allowed to participate in the Camp, I hereby, on behalf of myself, any above-named minor(s), and our respective assigns, beneficiaries, heirs, personal representatives, trustees, and other successors or representatives, voluntarily and forever release, waive, and discharge The Dance Palace, and their respective employees, volunteers and representatives, from and against, and hereby covenant not to sue any of them regarding, any and all causes of action, claims, damages, injuries, liabilities, or losses (including, without limitation, such that may in any way arise from, be connected with, or relate in any way to the Camp or the negligence of The Dance Palace, or any of their respective employees or representatives) arising out of or in any way resulting from the Camp or our participation in or involvement with the Camp or any related activities or programs. In return for sufficient good and valuable consideration, I hereby indemnify, hold harmless, and defend The Dance Palace from and against any and all causes of action, claims, damages, injuries, liabilities, or losses that in any way arise out of, are connected with, or result from my or any above-named minor(s) participation in or involvement with the Camp or any related activities or programs. Such indemnification and hold harmless terms shall apply and be fully enforceable even if such injury or damage arises out of the negligence of The Dance Palace, Virtual DPC, or any of their respective directors, employees, officers, agents, or representatives and shall include, without limitation, The Dance Palace’s reasonable attorney’s fees associated therewith.
I, on behalf of myself and any above-named minor(s) and our respective assigns, beneficiaries, heirs, successors, and other representatives, agree that the waiver and release, assumption of risk, and indemnification, hold harmless, and defense provisions stated herein are intended to be as broad and inclusive as is permitted by the laws of the State of California and that if any portion thereof is held invalid, the balance shall, notwithstanding such invalidity of any portion, continue in full force and effect.
I have read this document, fully understand its terms, and understand that I, on behalf of myself and any above named minor(s), am through this document giving up substantial rights, including, among others, the right to sue and undertaking substantial obligations, including, among others, indemnification.
I acknowledge that I am agreeing hereto freely and voluntarily and intend this acknowledgement (whether hard copy or electronically transmitted) to be a complete and unconditional release of liability.
Signing below confirms that you have read the camp information on the website, above permission statements, that you understand it, and that you agree to be bound by it.
Do not sign here. You will be given a pdf to print and return to the Dance Palace.