Waiver, Release, and Hold Harmless Agreement

In consideration of permission granted by the Jackson Ballroom Dance Club, Inc. (Jackson Ballroom Dance Club)allowing me to participate in Ballroom Dance (the "Activity") sponsored by the Jackson Ballroom Dance Club, atwhatever location, I (together with my parent or guardian, if I am under the age of eighteen or under a legal disability)

represent, covenant and agree, on behalf of myself and my heirs, assigns, and any other person claiming by, under or through me, as follows:

1. I acknowledge that participating in the Activity involves certain risks (some of which I may not fully appreciate) and that injuries, death, property damage or other harm could occur to me or others. I accept and voluntarily incur all risks of any injuries, damages, or harm which arise during or result from my participation in the Activity, regardless of whether or not caused in whole or in part by the negligence or

   other fault of the Jackson Ballroom Dance Club, and/or its members, affiliates, employees, officers, agents or insurers, the Pat Brown School of Dancing and/or its members, affiliates, employees, officers, agents, or insurers, Kimberly A. Turner d/b/a Pat Brown School of Dancing, and/or her beneficiaries, heirs, agents, and assigns, and Pat Brown Seltzer, d/b/a Pat Brown School of Dancing, and/or her beneficiaries, heirs, agents, and assigns. ("Released Parties").

   
   

2. I waive all claims against any of the Released Parties for any injuries, damages, losses, or claims, whether known and unknown, which arise during or result from my participation in the Activity, regardless of whether caused in whole or part by the negligence or other fault of any of the Released Parties. I release and forever discharge the Released Parties from all such claims.

   
   

3. Whether I am a member or a guest, I agree to indemnify and hold the Released Parties harmless from all losses, liabilities, damages, costs or expenses (including but not limited to reasonable attorneys'; fees and other litigation costs and expenses) incurred by any of the Released Parties as a result of any claims or suits that I (or anyone claiming by, under or through me) may bring against any of the Released Parties to recover any losses, liabilities, costs, damages, or expenses which arise during or result from my participation in the Activity, regardless of whether or not caused in whole or part by the negligence or other fault of any of the Released Parties.

   
   

4. I have carefully read and reviewed this Waiver, Release and Hold Harmless Agreement. I understand it fully and I execute it voluntarily.

   
   

5. I understand that the Jackson Ballroom Dance Club reserves the right to eject any person(s) deemed unruly or unfit to stay within the activity.

   
   

6. I acknowledge that this Waiver, Release and Hold Harmless Agreement remains in effect for each and every occasion that I participate in the Activity and for as long as I continue to participate in the Activity, regardless of the location of the Activity.