Little Lotus Company

Class Waiver

do hereby consent to his/her participation in "Little Lotus Company®" dance class, rehearsal and or performance, 
I acknowledge that participation in these dance class(es), rehearsal(s) and or performance(s) may expose the above named student to the possibility of injury. I grant "Little Lotus Company" staff the authority to obtain emergency medical treatment as necessary to insure that the above named student is safe from further injury. In consideration of "Little Lotus Company®" allowing this student to participate in its dance class(es), rehearsal(s) and or performance(s), I agree to waive and release "Little Lotus Company®" from all claims for damages that may arise, other than by negligence of "Little Lotus Company®", its employees and agents, as a result of my child’s participation in its dance class(es), rehearsal(s) and or performance(s) .

Media Waiver 
I am aware that the above named student may appear in a photograph, or video, taken by "Little Lotus Company®" staff or local media and that photograph or video may appear in a variety of media sources on behalf of "Little Lotus Company®". 
Please note, that under no circumstances will "Little Lotus Company®" divulge your child’s name without express written permission.

Transportation Waiver
I acknowledge that the above named student may be participating in activities, trips and events organized by "Little Lotus Company®". I am aware that the participation of my child may be outside the scope of his/her daily routine. I give permission for my child to travel by foot, automobile, or bus to a desired location.

I acknowledge and confirm that I have read this entire document prior to signing below.
You may fill out the form above and submit, 
or click to download, print & sign: LLCo. Class Waiver.
Please bring signed waiver to first day of class.