Stick and Move Youth Crew Registration Page
Fall Session -Sept. 17th - Dec. 17th

Parent/Guardian 1

Parent/Guardian 2


Dancer's Info



Photo/Audio/Video Consent and Release 


Waiver, Indemnity and Release 


I hereby grant permission to Jonathan St. Clair, Stick and Move Youth LLC (SMYC), and its representatives to take photographs, videos, audio, of my child (participant) and to make recordings at all workshops, programs, events, and event locations. I further grant to the producers (Jonathan St. Clair & SMYC) and their representatives the right to reproduce, use, exhibit, display, broadcast and distribute and create derivative works of these images and recordings in any media now known or later developed. I acknowledge that the producers own all rights to the images and recordings.

I hereby waive any right to inspect or approve the use of the images or recordings or of any written copy. I also waive any right to royalties or other compensation arising from or related to the use of the images, recordings, or materials. I hereby release, defend, indemnify and hold harmless the producers from and against any claims, damages or liability arising from or related to the use of the images, recordings or materials, including but not limited to claims of defamation, invasion of privacy, or rights of publicity or copyright infringement, or any misuse, distortion, blurring, alteration, optical illusion or use in composite form that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution.

I have read this document before signing below, and I fully understand the contents, meaning and impact of this consent, waiver, indemnity and release. This consent, waiver, indemnity and release is binding on me, my heirs, executors, administrators and assigns.

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