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Sakachez® Waiver and Photo Release

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Do you have a doctor’s permit to participate in intense physical activities?

Yes

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I declare that the info I’ve provided is accurate & complete

I hereby indemnify, release and forever hold harmless Sakachez®, Lainie Sakakura, Alex Sanchez, and New York Live Arts Inc. including its employees, instructors and volunteers from any and all claims of liability arising from any accident, personal injury, death, property loss or damage sustained by my child(ren)/myself/the minor child(ren) for whom I am a legal guardian (the “Participant”), while the Participant is engaged in activities connected with Sakachez® including classes, rehearsals, performances, or other activities, or is located on any of the premises utilized by Sakachez® and New York Live Arts Inc. before, during, or after such activities. I understand that dance activities have inherent risks of injury, and, being fully aware of all risk. I consent to have the Participant participate in the classes and activities offered by Sakachez®, Lainie Sakakura, Alex Sanchez, and I accept full responsibility for providing adequate health and accident insurance coverage for the protection of the Participant. By accepting and consenting to this statement, I declare that the Participant is in good health, with no physical conditions that might prevent participation in strenuous and rigorous dance activities and other training and performance connected with dance.

I hereby consent to the photographing and/or recording of myself and of myself and of my voice and the use of these photographs and/or recordings, singularly or in conjunction with other photographs and/or recordings, for Sakachez® advertising, publicity, commercial or other business purposes. I understand that the term “photograph” as used herein encompasses both still photographs and motion picture footage. I further consent to the reproduction and/or authorization by Sakachez® to reproduce and use said photographs and recordings of myself and my voice, for use in all domestic and foreign markets. Further, I understand that others, with the consent of Sakachez® may use and/or reproduce such photographs and recordings. I hereby release Sakachez® and any of its representatives from all claims of every kind on account of such use.

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