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Please upload a photo or scan of the front AND back of the student's medical insurance card.
Liability Release As the enrolled participant and/or the parent/guardian of a R.O.A.D. Scholar, I agree and understand that dance/fitness training is a potentially hazardous activity. I recognize that there are risks inherent in dance training including but not limited to serious physical injury. The participant hereby agrees to participate in activities of the Kansas City Ballet and hereby agrees to indemnify and hold harmless KC Ballet, its instructors, officers, directors, agents and employees against any liability resulting from any injury that may occur to the participant while participating in activities of KC Ballet. The participant also agrees to indemnify KC Ballet for any damages incurred arising from any claims, demand, action or course of action by the participant. The participant authorizes any representative of KC Ballet to have the participant treated in any medical emergency during their participation in activities of KC Ballet. Further, the participant and/or parent/guardian agrees to pay all costs associated with medical care and transportation for the participant. Any medical/health issues of which the staff should be aware are disclosed on the Health History Form. The parent/guardian will keep KC Ballet informed of any changes in the participant’s health. Photography/Videography/Social Media Release As the enrolled participant and/or the parent/guardian of a R.O.A.D. Scholar, I authorize Kansas City Ballet and/or its representative, agent or employee to photograph and/or videotape and use any photograph/ likeness of me or my minor child for any purpose, including publicity, choreographic archives, promotional materials, KCB social media, and/or any other reason deemed appropriate by KC Ballet’s Community Engagement and Education Director and School Director.
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