SQUARE STUDIO DANCE Full Assumption of Risk and Release of Liability Related to Participation in Activities Form READ CAREFULLY BEFORE SIGNING. THIS FULL RELEASE IS AN ENFORCEABLE CONTRACT BETWEEN YOU AND SQUARE STUDIO DANCE, AN OREGON NONPROFIT CORPORATION exempt from taxation pursuant to IRC §501(c)(3). IT INCLUDES A RELEASE OF LIABILITY AND WAIVER OF CERTAIN LEGAL RIGHTS. THIS FULL RELEASE COVERS ALL ACTIVITIES YOU PARTICIPATE IN FROM THE DATE YOU SIGN BELOW TO JANUARY 1 THE FOLLOWING YEAR. In consideration of being allowed to learn from and participate in any of the activities or programs (collectively “Activities”) sponsored by Square Studio Dance, you acknowledge and agree as follows: I. POTENTIAL RISKS. Participation in Activities involves risks. It is not possible to compile a complete listing of the risks. However, they include the possibility that you may suffer serious, even fatal, injury or illness, although the nature of these activities makes such injury or death unlikely. By signing this form, you acknowledge that you understand that there could be dangers involved in the Activities you will be participating in, including, but not limited to: Personal injuries, Physical injury, Psychological injury, Illness, Paralysis, Pain and Suffering, Disfigurement, Temporary or permanent disability, Injuries to other persons, Death, and Property Damage to your property or the property of others. In the event of a medical emergency, I authorize Square Studio Dance to contact the proper authorities as necessary as well as the emergency contacts identified above on behalf of me or my Child. II. YOU ASSUME ALL RISKS. You acknowledge that you voluntarily, knowingly, and freely assume, and take full responsibility for all risks, known and unknown, related to your participation in the Activities, and you further acknowledge that you are entirely responsible for deciding whether to participate in any Activities with Square Studio Dance and for deciding in which Activities you can safely participate. Additionally, since a majority of the Activities will be provided by Square Studio Dance via the internet, you will be completely responsible for selecting the location in which you will participate in the Activities, and you voluntarily, knowingly, and freely assume, and take full responsibility for all risks, known and unknown, related to your selected location and whether the Activities can be safely performed in that location. III. YOU RELEASE ALL CLAIMS AGAINST SQUARE STUDIO DANCE AND THE PERSONS LISTED IN PARAGRAPH IV. You hereby agree for yourself and for your heirs, relatives, representatives, estate, agents, and assigns, that you will not hold Square Studio Dance liable, or any of the persons listed in Paragraph IV below, and that you will waive and release any claims, demands, or actions against them, for any damages to, or loss of, your property or the property of others in connection to your participation in the Activities, or for your injury or death, or the injury or death of others, which results from or arises in connection with your participation in the Activities of Square Studio Dance including as a result of negligence by Square Studio Dance, or any of the persons listed in Paragraph IV, other than that which results from gross negligence, wanton or willful misconduct, or reckless or intentional conduct. You understand that this waiver includes a waiver of liability for acts of negligence. In addition, you agree to indemnify Square Studio Dance, and the persons listed in Paragraph IV, for any claims made against them, on your behalf or otherwise, as a result of any damage to, or loss of, your property or the property of others, your injury or death, or the injury or death of others which arises in connection with your participation in the Activities of Square Studio Dance including as a result of negligence by Square Studio Dance, or any of the persons listed in Paragraph IV, other than that which occurs as a result of gross negligence, wanton or willful misconduct, or reckless or intentional conduct. IV. THE FOLLOWING ORGANIZATIONS AND PERSONS ARE COVERED BY THIS FULL RELEASE. The persons and organizations covered by this Full Release include: Square Studio Dance and its directors, officers, members, staff, employees, volunteers, agents and representatives, and any others who participate in the Activities of Square Studio Dance, or who volunteer for, or perform work for, Square Studio Dance. V. IF YOU ARE A PARENT OR LEGAL GUARDIAN OF ANY PARTICIPANT WHO IS YOUNGER THAN 18 (“CHILD”), YOU ASSUME ALL RISKS AND RELEASE ALL CLAIMS ON BEHALF OF YOUR CHILD. If you are the parent or legal guardian of a Child, YOU ASSUME ALL RISKS AND RELEASE ALL CLAIMS on behalf of your Child and your Child’s heirs, assigns, personal representatives, and next of kin in the same manner, and to the same extent, as you do for yourself in this Full Release. Further, wherever the terms “I,” “me,” “my,” “myself,” “you,” or “your,” are used in this Full Release, those terms shall be interpreted to cover the Child participant for whom you are signing. VII. SEVERABILITY. If any provision of this Full Release, or the application of a provision to any person or circumstance, is held invalid, the remainder of this Full Release, or the application of that provision to other persons or circumstances, must not be affected thereby. VIII. GOVERNING LAW. This Full Release shall be interpreted according to the laws of the State of Oregon, and the parties consent to the personal jurisdiction of the Lane County Circuit Court in the State of Oregon. Nothing in this article shall preclude the parties from attempting to resolve conflicts through mediation or arbitration. THIS FULL RELEASE IS INTENDED TO PROTECT THE PARTIES IN PARAGRAPH IV FROM LIABILITY FOR INJURIES TO YOU, YOUR CHILDREN, AND YOUR PROPERTY TO THE MAXIMUM EXTENT ALLOWED BY OREGON LAW. Photo Release Square Studio Dance occasionally uses photos and videos, of and by volunteers and participants, in its newsletter, web, and print publications. I agree that Square Studio Dance may use any photos and videos I appear in or have provided to Square Studio Dance. I understand and agree that photographs and video recordings of me may be placed on the Internet and used in other formats and copyrighted works. I also understand and agree that I may be identified by name or title in print, internet, or broadcast information that might accompany the photographs and video recordings of me. I waive the right to approve the final product. I agree that all such photographs and video recordings, and any reproductions thereof, are and shall remain the property of Square Studio Dance and that I have no right, title, or interest in or to any of the foregoing. If you are the parent or legal guardian of a participant younger than 18 (a “Child”), you agree to the Full Release and Photo Release above on behalf of your Child in the same manner, and to the same extent, as you do for yourself in this Full Release and Photo Release. Further, wherever the terms “I,” “me,” “my,” “myself,” “you,” or “your,” are used in this Full Release or Photo Release, those terms shall be interpreted to cover the Child participant for whom you are signing. The undersigned has read this Full Release and Photo Release and understands its terms. This Full Release and Photo Release is executed freely and voluntarily, with full understanding that the undersigned is giving up substantial legal rights. Participant's Name *

I have read and I understand this Full Release and Photo Release, and I am signing it voluntarily on behalf of myself and/or my Child.