Please specify below your number of years of dance experience/ education in the following styles:
Contemporary, Jazz, Ballet, Other
INDEMNIFICATION and RELEASE
I am the parent or guardian of____________________________, who desires to attend the Eisenhower Dance Detroit
Intensive at Detroit Opera House 2018. The Summer Intensive includes dance training and educational activities on site
at the Detroit Opera House. I understand that there is risk of injury inherent in the dance training and educational activities
included in the Summer Intensive, and that Eisenhower Dance, Michigan Opera Theatre and its employees shall not be
responsible for any injuries or damages suffered by my child caused by the negligence of Eisenhower Dance, Michigan
Opera Theatre, or the agents, employees or directors of this institution, During my child’s participation in recreational
activities and any other activity taken in connection with the Summer Intensive.
Furthermore, I hereby agree to indemnify and hold harmless Eisenhower Dance, Michigan Opera Theatre and/or all
agents, employees and directors of its institution (Collectively the “Indemnified Parties”) for any loss, claim, damage, suit,
costs or expenses, including attorney’s fees and court costs, resulting from or arising out of any injury to any person or
damage to property, caused by or incurred by myself, my child, and/or my ward, or whether caused in whole or in part by
the negligence of the indemnified parties, incurred as a result of or during the Eisenhower Dance Detroit Intensive at the
Detroit Opera House or any activities in connection with this program.
In consideration of Eisenhower Dance and Michigan Opera Theatre’s acceptance of my child into the Summer Intensive, I
do hereby voluntarily waive and release any and all actions, claims, and demands for any damage, injury, and loss to
person or property that may be sustained participating in the Eisenhower Dance Detroit Intensive at the Detroit Opera
I hereby consent to have my child photographed, videotaped, filmed, audio taped and/or interviewed by the media, and
grant the rights in perpetuity from the time he or she enters the studios for the Eisenhower Dance Detroit Intensive at the
Detroit Opera House.
PARTICPIANT INFORMED CONSENT
I understand that as the parent/guardian of the above participant(s), I agree to be accessible by phone in case of an
emergency and be available to pick up my child if needed. If my child requires additional support, I may be asked to stay
for the duration of the program or provide a staff person to assist him or her. In addition, I have provided the necessary
*PLEASE TYPE PARTICIPANT'S NAME BELOW, FOLLOWED BY YOUR NAME (PARENT/GUARDIAN, IF UNDER THE AGE OF 18)
By typing your name below, you are agreeing to the terms listed above.