I recognise that participating in this activity risks of serious injury or death, including but not limited to temporary or permanent muscular or skeletal injury and paralysis. I assume total responsibility for any property damage and/or injury caused in connection with his/her/their participation in dance at Bailar Kizomba. I understand that this Release Agreement is a contract and shall protect me and remain in effect for the duration of my participation at Bailar Kizomba classes/parties.

I give Bailar Kizomba and it's affiliates the permission to take and use my and/or family's likeness and photograph to promote or represent in it's program(s).

I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS APPLICATION AND RELEASE FROM LIABILITY AND INDEMNITY BY READING THIS AGREEMENT BEFORE SIGNING IT.

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Name
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