Collect Dance Waivers & Medical Consent Online in Minutes

Protect your studio with a ready-to-use dance waiver covering assumption of risk, liability release, emergency medical consent, and dancer health details.

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Dance Studio Class Participation Liability Waiver & Emergency Medical Consent Form

Dancer's Full Name

· · ·

Dancer's Date of Birth

· · ·

Class(es) Enrolled

Submit

This Dance Studio Class Participation Liability Waiver and Emergency Medical Consent Form template gives your studio one organized place to collect everything you need before a dancer steps onto the floor. It gathers the dancer's name, date of birth, and enrolled classes. It also collects parent or guardian contact details, a separate emergency contact, medical conditions, allergies, medications, past injuries, physician information, and health insurance details. Pre-written sections cover assumption of risk, release of liability, and emergency medical consent. Acknowledgment statements at the end let parents or adult dancers confirm they agree to the terms.

The template is built for dance studios, ballet schools, performing arts academies, competition teams, and instructors who teach recreational or competitive classes for children, teens, and adults. It works for ballet, jazz, tap, hip-hop, contemporary, and acro classes. The waiver language addresses the physical demands of dance, including jumps, turns, lifts, partnering, and floor work. It applies to classes, rehearsals, recitals, competitions, and studio events.

Moving your waiver online replaces paper packets and keeps records organized and searchable. It also helps instructors quickly find medical and emergency information when it matters most. Families can complete the form from any phone or computer during registration, which cuts front-desk paperwork and missing forms. You can customize the wording, add your studio name and logo, include a signature field, or connect the form to your enrollment process. We recommend having your final waiver reviewed by a local attorney to confirm it meets the requirements in your state or region.

3 Pages

20 Questions

~7min To complete

Free Included on every plan

Field types Full Name ×4 Phone ×3 Date ×2 termsandconditions ×2 Multiple Choice Email Address Dropdown Long Text Short Text richtext Yes / No Signature

Questions in this template

Free template

The exact questions included — customize any of them to fit your needs.

Page 1 Dancer & Parent/Guardian Information 7 questions

Dancer & Parent/Guardian Information

1 Dancer's Full Name * Full Name

2 Dancer's Date of Birth * Date

3 Class(es) Enrolled * Multiple Choice

4 Parent / Legal Guardian Name (required if dancer is under 18) Full Name

5 Email Address * Email

6 Primary Phone Number * Phone

7 Home Address * Address

Page 2 Emergency Contact & Medical Information 7 questions

Emergency Contact & Medical Information

1 Emergency Contact Name (other than the person completing this form) * Full Name

2 Emergency Contact Phone Number * Phone

3 Relationship to Dancer * Dropdown

4 Please list any medical conditions, allergies, current medications, or past injuries (e.g., asthma, epilepsy, joint or back problems). Enter 'None' if not applicable. * Long Text

5 Primary Physician Name Full Name

6 Physician Phone Number Phone

7 Health Insurance Provider & Policy Number Short Text

Page 3 Waiver, Consent & Signature 6 questions

Assumption of Risk, Release of Liability & Medical Consent

1 ASSUMPTION OF RISK: I understand that dance classes, rehearsals, and performances involve vigorous physical activity, including stretching, jumping, turning, leaping, partnering, lifts, floor work, and acrobatic movements. These activities carry an inherent risk of injury, such as sprains, strains, muscle tears, fractures, and concussions. I confirm the dancer is in good health and physically able to participate. I knowingly and voluntarily assume all such risks.RELEASE OF LIABILITY: In consideration of being permitted to participate, I release, waive, and hold harmless the studio, its owners, instructors, employees, and volunteers from any and all claims, damages, or losses arising from participation in classes, rehearsals, recitals, competitions, and studio events. This release does not cover losses caused by gross negligence or willful misconduct. I agree that the dancer will follow all instructor directions and studio safety rules.EMERGENCY MEDICAL CONSENT: In the event of injury or illness, I authorize studio staff to administer first aid. I also authorize staff to obtain emergency medical treatment, including ambulance transport to the nearest hospital, whenever they deem it necessary, even if I cannot be reached. I consent to the release of the medical information on this form to treating medical personnel. I accept financial responsibility for all resulting medical costs. richtext

2 I have read and understand the Assumption of Risk and Release of Liability above, and I voluntarily agree to its terms on behalf of myself and/or my minor child * termsandconditions

3 I authorize emergency medical treatment for the dancer as described above, confirm that all medical information provided is accurate and complete, and accept financial responsibility for any related costs * termsandconditions

4 Photo & Video Release: May the studio photograph or record the dancer during classes, rehearsals, and performances for use on its website, social media, and promotional materials? * Yes / No

5 Signature of Adult Participant or Parent / Legal Guardian * Signature

6 Date Signed * Date

How to use this template

Click "Use This Template Free" to open it in the FormBuilder editor. From there you can add, remove, or reorder fields with drag-and-drop, switch themes for instant restyling, add your logo, configure email notifications, and set your success message. When ready, publish with a unique link and start collecting responses immediately.