DUCON Malaysia Pd - Runqiao Du

MAY 31 – JUNE 3, 2023

Dancer's Information

Name(Required)

First Last

Phone(Required)

Email(Required)

Age(Required)

Please enter a number from 9 to 22.

Please list the age of the dancer as of June 1, 2023.

Select Level(Required)

LVL 2 (Ages 9-11)

Current Dance School(Required)

Years of Ballet Experience(Required)

Years of Pointe Experience(Required)

Are there any health related concerns that we should know about (allergies, doctor's note, etc)?(Required)

Parent's Information

Parent's Name(Required)

First Last

Parent's Phone(Required)

Parent's Email(Required)

I agree to the Terms of Service, liability waiver & media release.

Must be 18 and over to sign this agreement.

Terms of Service

Liability Waiver

I, the undersigned, In consideration of being allowed to participate in an event or program sponsored by Runqiao Du, LLC’, understand and expressly assume all risks involved in connection with dance instruction, rehearsal, training, and performance at Runqiao Du, LLC, whether in person or through remote learning via the internet, including but not limited to risk of bodily injury occurring as a result of contact with other students, instructors, walls, equipment, floors, structural poles, and other objects located in or near dance studios or in any location at which dance instruction, rehearsal, training, or performance Is taking place, or my physical condition or physical limitations, and I warrant that I am physically fit and able to participate in all activities involved in dance instruction, rehearsal, training and Performance and assume the risk of such.

I hereby irrevocably release, waive, discharge, indemnify and hold harmless Runqiao Du, LLC, its successors and assigns, its oficers, directors, shareholders, employees and agents, and their heirs, executors, and administrators (“RELEASES”) from any and all claims, demands, suits, actions, causes of action, costs, ‘expenses, losses, awards, judgments, injuries or damages (including reasonable attorney fees and related costs incurred by any of the RELEASEES) caused or alleged to have been caused by RELEASEES to me ormy child/children in connection with his/her/their/my participation or engagement in any Runqiao Du, LLC program including, but not limited to, claims arising out of dance instruction, rehearsal, training, and performances, provided by Runqiao Du, LLC whether caused by negligence or otherwise, and whether for bodily injury, property damage, or loss or otherwise, which I may ever have against the RELEASEES.

I HAVE READ THE ABOVE WAIVER, RELEASE, AND INDEMNIFICATION OF LIABILITY AND I UNDERSTAND THAT I AM VOLUNTARILY GIVING UP CERTAIN RIGHTS BY SIGNING IT.

Media Release:

I understand, accept and grant permission for images/video/audio of myself or my child/children to be published or exhibited for editorial and/or publicity purposes without limitation or reservation or prior inspection. I waive any right to royalties or other compensation arising or related to the Use of the images/video/audio, I further release Runqiao Du, LLC, its successors and assigns, its officers, directors, shareholders, employees and agents, and their heirs, executors, and administrators from any and all claims, including, but not limited to, those based on libel, invasion of privacy or violation of any right of publicity. The absence of, or lack of explicit mention to a specific claim does not limit the extent of the application of this agreement. This consent shall be irrevocable,

I attest that I am at least 18 years of age and I accept and agree to the above terms on my own behalf.

*There will be no refunds for this program.*