Blueprint Dance Company

Technique Lab: Waiver

Please complete the form below prior to your child’s participation in the Blueprint Dance Company Technique Lab: 3-Day Intensive.

A separate waiver form is needed for each participating dancer.

Dancer Information

Dancer Full Name

Dancer Date of Birth

Month

Day

Year

Parent Information

Parent/ Guardian Full Name

Parent/ Guardian Email

Parent/ Guardian Phone Number

Health and Emergency Information

Does your child have any allergies, medical conditions, injuries, or accommodations that may affect participation in Technique Lab?

Emergency Contact Name

Emergency Contact Phone Number

Emergency Contact Relationship to Dancer

My dancer is physically able to participate and I have disclosed any medical conditions that may affect participation.

Liability & Participation Waiver

Please read carefully before signing.

Liability Waiver

I, the undersigned parent/guardian, grant permission for my child to participate in the Blueprint Dance Company Technique Lab Intensive. I understand that participation in dance training, conditioning activities, and performance experiences involves inherent risks, including but not limited to falls, muscle strain, or injury. I voluntarily assume all risks and agree not to hold Blueprint Dance Company, its coaches, staff, volunteers, or partner facilities liable for any injuries, accidents, or damages that may occur as a result of participation.

In the event of an emergency, I authorize reasonable emergency medical care if a parent/guardian cannot be immediately reached.

Media & Photo Release

I grant Blueprint Dance Company permission to photograph and record my child during Technique Lab classes, performances, and program activities. I understand that photographs and video footage may be used for social media, marketing materials, website content, and other promotional purposes without compensation.

All media will be used respectfully, with student safety and dignity as a priority.

I have read, understand, and agree to the Liability Waiver, Media & Photo Release and all Blueprint Dance company participation requirements.

Parent/ Guardian Electronic Signature

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