Waiver Form

I, the undersigned participant (or parent/guardian if the participant is a minor), do hereby  choose to participate or have my child participate in the Historical Tea Dance Socials (or  other events - “the events”) presented by the Historical Tea & Dance Society (HTDS). I further acknowledge and under-stand that by participating in the events, there is a possibility that the participant may sustain physical injury or illness in connection with his or her participation. I further acknowledge and understand that I am assuming the risk of such physical injury or illness by this participation. I further hold HTDS, event locations and personnel, and  event instructors, coordinators, and volunteers (“event management”) harmless against all damages, claims, liabilities, expenses, or judgments, including attorney’s fees and court  costs, arising out of participation in this event. 

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Furthermore, I acknowledge and understand that failure to observe the instructions of event  manage-ment can increase the risk of physical harm to myself or others. I understand that violation of any event or venue rule as laid out by event management can result in dismissal from the event. 

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I understand that in the unlikely event of an injury or illness during the events, if the participant is in-capacitated or otherwise unable to make a decision about seeking medical care, there will be an attempt to notify the emergency contact at the phone number below prior to seeking medical treat-ment for me or my child for such injury or illness. I hereby hold event  management harmless in the exercise of authority for injuries or illness that a participant may sustain during the event. I further acknowledge and understand that I will be responsible for any medical bills that may be incurred on my behalf for physical illness or injury that my child or I may sustain during the event. 

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PHOTO RELEASE: In addition, I give permission for myself or my child to be photographed while participating in the event. I understand that photographs of event participants may be used by HTDS in future online or print-media publicity; participant names will not be used unless a HTDS representative has obtained prior consent from the adult participant or minor’s parent/guardian.