Registration | toydrive

PHOTO/IMAGE RELEASE: I give my consent for images (photographs, video) of me to be taken and used to document the activities of Angel Rodriguez Dance Instructor herein referred to as Salsa Guy Richmond. I grant Salsa Guy Richmond permission to use the images for educational and promotional purposes. I understand that if I do not want images of me used, I will indicate this in writing in form of a signed letter and will attach it to this document.

MEDICAL RELEASE: I give my permission to Salsa Guy Richmond in case of emergency, if my of the above emergency contact person cannot be contacted; give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve my life, limb or well-being. I accept full responsibility for all costs of said medical care and any emergency treatments. Salsa Guy Richmond will not be responsible for the cost of any medical care or emergency treatments. I hereby waive all claims whatsoever in connection with such medical treatments.

WAIVER AND RELEASE: I agree that if my I engage in any physical exercise, class, or activity, or facility on the premises or any venue where I participate voluntarily for personal entertainment or as a representative of Salsa Guy Richmond, I do so at my own risk. I agree that I voluntarily participate in activities and use of said facilities, premises (including the parking lot) designated by Salsa Guy Richmond. I assume all risk of injury, illness, damage, or loss to us or our property that might result, including, without limitation, any loss or theft of any personal property. I agree that this consent and assumption of risk statement covers each and every event or activity sponsored by Salsa Guy Richmond. I agree to release and discharge Salsa Guy Richmond (and your affiliates, employees, agents, representatives, successors, and assigns) from any and all claims or cause of action (known or unknown) arising out of your negligence. I acknowledge that I have carefully read this Waiver and Release and fully understand that it is a release of liability. I am waiving any right that I may have to bring legal action to assert a claim against Salsa Guy Richmond.

4th Annual