Liability and Waiver Form
We know that you never read these things...
However, we suggest that you take the time to go over this form in the comfort of your home so that you don't have to read it while registering! *Forms will be available with your packet
Explanation of the Myrtle Beach Latin Dance Conference
All participants of the Myrtle Beach Latin Dance Conference are responsible for their arrival and registration on the designated date/time. Only a designated person identified by the individual that purchased pass will be able to pick up or trade their registration packet. The Myrtle Beach Latin Dance Conference shall take place at 2001 NightClub on September 26th 2008 through September 28th 2008. The day will begin with registration followed by the opening Latin dance party. Participants must register for classes as they arrive to secure a spot in the limited space dance classes. On the following date, participants will attend classes during the day. This will be follow by a mid-day lunch intermission. Classes will proceed and will end with a dinner intermisson followed by an Open Stage Show, and the second dance party of the event. On the third day classes will be offered only for two periods, a closing ceremony will be held followed by a beach party.
We ask that all participants consider themselves as professionals and comply with rules and regulations. Lets make this year's event as safe and enjoyable for every one. We advise that every one check in and out as they leave the venue to ensure your safety. UST BE READ BEFORE SIGNING THE FORM
ACKNOWLEDGMENT OF RISK
Participants understand that certain risks and hazards may be present when participating in courses and activities of this event. These may include but are not limited to injuries, illness or death, property damage and/or loss, or other strenuous/hazardous activities, etc. I certify that I am aware of the nature and type of classes that I and/or my child are registered for, and in consideration of the benefits of such activities, acknowledge and accept the potential for such risks, as well as agreeing to the conditions for participation in terms listed hereafter.
PARTICIPATION AUTHORIZATION, INFORMED CONSENT,
RELEASE OF LIABILITY, AND MEDICALTREATMENT CONSENT
I HEREBY CERTIFY THAT I HAVE READ AND FULLY UNDERSTAND THE NATURE AND SCOPE OF THE EVENT AS PROPOSED ON THE WEBSITE, AND FURTHER UNDERSTAND THE POTENTIAL RISKS INHERENT IN SUCH ACTIVITIES AND PARTICIPATION AS DESCRIBED ON THE WEBSITE , AND/OR IN MEETINGS WITH INSTRUCTORS. I THEREFORE AGREE TO AND ACCEPT THE RULES AND GUIDELINES AND TO FURNISH AND WEAR OR USE ANY REQUIRED SAFETY EQUIPMENT SPECIFIED OR SUGGESTED FOR PARTICIPATION IN THE ACTIVITY AS DESCRIBED ON THIS WEBSITE. I AUTHORIZE PARTICIPATION BY MY CHILD IN THE ACTIVITY DESCRIBED ON THIS WEB SITE , AND CONSENT TO SUPERVISION OF MY CHILD BY AN ADULT DANCE INSTRUCTOR DURING THIS EVENT. I UNDERSTAND THAT NORMAL SAFETY PROCEDURES AND LEADERSHIP GUIDELINES WILL BE IMPLEMENTED DURING THIS ACTIVITY. I FURTHER RECOGNIZE THAT CERTAIN RISKS MAY BE INHERENT IN THE CONDUCT AND PARTICIPATION IN THIS ACTIVITY WHICH MAY BE BEYOND THE CONTROL OF ADULT LEADERS AND/OR ACTIVITY SPONSORS. I FURTHER CERTIFY THAT I AND/OR MY CHILD IS/ARE MEDICALLY AND PHYSICALLY CAPABLE OF PARTICIPATING IN THIS EVENT AND IS/ARE MEDICALLY CLEARED BY A PHYSICIAN FOR PARTICIPATION IN SUCH ACTIVITIES. IN RECOGNITION OF THE BENEFITS DERIVED BY MYSELF AND/OR MY CHILD, AND IN THE EVENT OF ANY ACCIDENT RESULTING IN INJURY, ILLNESS, DISABILITY, OR DEATH, PROPERTY LOSS OR DAMAGE, WHICH MIGHT OCCUR TO MYSELF AND/OR MY CHILD, WHILE TRAVELING TO OR FROM, OR DURING THE CONDUCT OF THIS EVENT, I AGREE TO INDEMNIFY, AGREE NOT TO SUE, AND AGREE TO HOLD HARMLESS, THE PARTICIPANTS OF THE MYRTLE BEACH LATIN DANCE CONFERENCE. EVENT SPONSORS, INSTRUCTORS, ADVISORS, LEADERS, OTHER EVENT PARTICIPANTS, AND ANY OR ALL AGENTS, EMPLOYEES, REPRESENTATIVES (OR THEIR EXECUTORS OR HEIRS) ACTING ON BEHALF OF SUCH ORGANIZATIONS OR INDIVIDUALS, FROM ALL CLAIMS DAMAGES, LOSSES, INJURIES AND EXPENSES ARISING OUT OF OR RESULTING FROM PARTICIPATION IN THESE ACTIVITIES. I FURTHER AGREE TO RELEASE, ACQUIT AND COVENANT NOT TO SUE THE AFORESAID PARTIES, INCLUDING THE DRIVERS OF VEHICLES TRANSPORTING MY CHILD FOR ANY AND ALL ACTIONS, CAUSES OF ACTION, CLAIMS OR DAMAGES, DAMAGES IN LAW OR REMEDIES IN EQUITY OF WHATEVER KIND, INCLUDING THE NEGLIGENCE OF THE AFORESAID PARTIES. I AGREE THE SITE OF ANY LAWSUIT AND THE LAW
GOVERNING ANY SUCH LAWSUIT SHALL BE GOVERNED BY SOUTH CAROLINA STATE LAW. THE TERMS OF THIS AGREEMENT SHALL CONTINUE AND BE IN EFFECT AFTER THE ACTIVITY HAS ENDED. AS LIQUIDATED DAMAGES, I HEREBY AGREE THAT IF MYSELF, MY EXECUTORS, OR MY HEIRS, ON MY FAMILY'S OR MY BEHALF, I AND/OR MY HEIRS OR EXECUTORS AGREE TO PAY SALSA QUEEN CO.
2001 NIGHTCLUB, AFRISALSA, LUIS BORIA, MILTON CLAVE, BLYTHE BROWN, GERRY OLIVIERY, BADI ELLIS, CHRIS McCULLEN, BRIAN WALTON AND ANY OR ALL SUCH ORGANIZATIONS OR INDIVIDUALS NAMED HEREIN, ANY COSTS AND ATTORNEY'S FEES INCURRED IF THEY SUCCESSFULLY DEFEND SUCH ACTION, LAWSUIT, OR ALLIGATION.
PHOTO RELEASE
I HEREBY ASSIGN AND GRANT TO SALSA QUEEN™ AND BORIAVISTA™ THE RIGHT AND PERMISSION TO USE AND PUBLISH THE PHOTOGRAPHS/ELECTRONIC OR SOUND RECORDINGS MADE OF ME THIS DATE BY SALSA QUEEN™ , AND I HEREBY RELEASE FROM ANY AND ALL LIABILITY SUCH USE AND PUBLICATION. I HEREBY AUTHORIZE THE REPRODUCTION, SALE, COPYRIGHT, EXHIBIT, BROADCAST, ELECTRONIC STORAGE AND/OR DISTRIBUTION OF SAID PHOTOGRAPHS/FILM/VIDEO TAPES/ELECTRONIC REPRESENTATIONS AND/OR SOUND RECORDINGS WITHOUT LIMITATION AT THE DISCRETION OF SALSA QUEEN™ AND BORIAVISTA™ AND I SPECIFICALLY WAIVE ANY RIGHT TO ANY COMPENSATION I MAY HAVE FOR ANY OF THE FOREGOING.
MEDICAL TREATMENT CONSENT
IN THE EVENT OF INJURY OR ILLNESS TO MYSELF AND/OR MY CHILD, I CONSENT TO ADMINISTRATION OF SUCH FIRST AID MEASURES AS MAY BE DETERMINED NECESSARY BY ACTIVITY LEADERS, AND IF DETERMINED NECESSARY, I FURTHER CONSENT TO TRANSPORT BY GROUND OR AIR
AMBULANCE AND/OR REFERRAL TO PHYSICIANS AND ADMISSION TO HOSPITALS. I FURTHER CONSENT TO EMERGENCY MEDICAL TREATMENT FOR MYSELF AND/OR MY CHILD IF DETERMINED NECESSARY, INCLUDING BUT NOT LIMITED TO, ANESTHESIA, INJECTION, SURGERY, X-RAY, AND MEDICATION, IF I
CANNOT BE CONTACTED IMMEDIATELY FOR SUCH CONSENT. I UNDERSTAND THAT REASONABLE EFFORTS WILL BE MADE TO CONTACT ME IN SUCH CASES.
All PARTICIPANTS ARE ENCORAGED TO PROVIDE INSURANCE INFORMATION AND INFORMATION
WHERE A FAMILY MEMBER CAN BE REACHED IN CASE OF AN EMERGENCY DURING THIS EVENT!!!
Thanks for taking the time to look this over!
Salsa Queen Productions™
