RAK Waiver

Name *

First Name

Last Name

By checking "YES", I understand that I assume full responsibility and shall indemnify and hold Ergo Arts Theatre and its contract artists harmless against any property damage, theft, personal injury or losses arising from my participation in the dance session organized by Jasmine Shaffeeulah as part of her Random Act of Kindness Project. *

YES

By checking "YES", I give consent to Ergo Arts theatre to use my name, portrait, and image (photo/video), for archival/promotional materials on their website (www.ergoartstheatre.com) and on social media outlets, including but not limited to Facebook, Instagram and Twitter. I agree that I shall have no claim, financial or otherwise against Ergo Arts Theatre or against anyone accessing the online publication of these photos/videos. I confirm that I am over 18 years of age and that I have not given anyone exclusive right to use my name, portrait, and image (photo/video). *

YES