New Form for Employees of NWA Dance/Twirl

Employee of NWA Dance/Twirl Studio

Name:_____________________

Address:_____________________

Phone Numbers:_____________________

Age:______________________

Health Conditions:________________________

Need a list of background you have in dance and or twirl:

__________________________________________________________________________________________________________________________________________

In consideration of MY participation as an instructor for the Northwest Alabama Dance/ Twirl Studio, I do herby, for myself, my heirs, and executors, waive release and forever discharge all rights and claims which may hereafter accrue to me against Nina Rae Long and any of its employees, and the Northwest Alabama Dance/Twirl Studio, and all injuries and or damages which may be suffered by me in my connection with my dependant participation as an instructor. I have read and understood the release and waiver of claims statement and fully agree with the provisions of this document.

Print Name:___________________________

Sign name:_____________________________ Date:____________________________