Miss Dance Team Iowa

Website: http://www.missdanceteamiowa.com/

When: November 4th, 2023

Where: Iowa City West High School

2901 Melrose AveIowa City, IA 52246

Cost: $105

Dancer Name(Required)

First Last

What school do you attend?(Required)

Year in School(Required)

For the 2023-2024 school year.

Date of Birth(Required)

Shirt Size(Required)

Dancer Email(Required)

Registration(Required)

Price:

Consent to Participate(Required)

I agree.

I understand that there are risks involved in participating that may include minor injury, major injury, paralysis or even death. I do hereby grant permission to medical staff members to administer treatment to me or my child in the event of injury or illness.

I also agree to hold harmless the hosting organization, hosting facility, and Form Dash, LLC for any and all liability for negligence or any other claim against the above parties, or for injury or illness incurred as a result of participation in this event.

The hosting organization retains the right to deny attendance or participation in hosting organization Activities if the hosting organization determines that such attendance or participation is an undue health risk. The hosting organization similarly has the right to deny any other individual from attending hosting organization activities if said individual’s attendance poses an undue health risk to that individual or others.

THE UNDERSIGNED KNOWINGLY AND FREELY ASSUMES ALL SUCH RISKS for attendance or participation in the hosting organization Activities.

The undersigned agrees that the undersigned will comply with any safety or health-related rules, terms, or conditions for participation in hosting organization Activities.

If participants or parent or legal guardian observe any unusual, significant hazard during their presence or participation in hosting organization Activities, participant or parent or guardian will remove the participant from participation and bring such observation to the attention of the nearest hosting organization employee.

After fully and carefully considering all the potential risks involved, I hereby assume the same and agree to release and hold-harmless the hosting organization and its employees, officers, agents, contractors and vendors (“hosting organization”) from and against, all claims and liability resulting from exposure to disease-causing organisms and objects, such as COVID-19, associated with Student participating in hosting organization Activities, to include, but not limited to educational, cocurricular, or extracurricular programs.

Check Out

Total

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code

Credit Card(Required)

Card Details

Cardholder Name

Where should we email your receipt?(Required)