RELEASE
Indicated in the space below are any health problems or conditions of which the studio should be aware such as
Hereby waive and release FUSION DANZ CENTRALE (FDC) individually and its staff from any and all claims or damages of any kind arising out of my participation in the exercise and/or dance program of FDC. I certify that I am in proper physical condition to participate in the exercise/dance program and that I have been examined by a licensed physician and found to be in proper physical condition to participate in said program. I, the undersigned, do herby authorize FDC or her designated agents (being teachers or administrators employed by FDC .) to obtain medical treatment for myself in emergency situations if needed. I understand that I am responsible for any medical expenses and that the absence of health insurance does not make responsible for payment of medical expenses. This authority includes the power to authorize any and all treatment deemed necessary under the circumstances by a licensed physician. This power is in essence a power of attorney and shall remain in effect for one year from the date signed below.
I understand that risk of injury is inherent in any physical activity and I knowingly and voluntarily accept that risk.
