Liability, Assumption of Risk and Media Release Form

Bhangra Dance or Fitness Classes with Gurdeep Pandher

Liability Release Form, Assumption of Risk Form, and Media Release Form

Liability Release and Assumption of Risk: – I am aware that bhangra dance is a hardcore workout or fitness activity.  Therefore, by participating in Gurdeep Pandher’s dance or fitness classes or activities could result in some possible personal injury. Despite safety precautions taken by Gurdeep Pandher, accidents and injuries may occur. By signing this release form, I (dancer or participant or student or parent/guardian) assume all risks related to participation in Gurdeep Pandher’s classes. I expressly release Gurdeep Pandher or his agents, employees, licensees, assigns, associates, partners, from and against any and all claims. I will not hold Gurdeep Pandher liable or responsible for any kind of personal or other injuries including physical or mental health or any personal property damage or loss, which may occur on the premises before, during or after classes.

Media Release: – I hereby grant permission/rights to Gurdeep Pandher to use my photos, videos, my name, likeness, voice made during the classes as promotional or communication material, in print or internet or in any other form of media. I expressly release Gurdeep Pandher, his agents, employees, licensees, assigns from and against any and all claims that I have or may have for invasion of privacy, defamation, copyright or any other cause of action arising out of the production, distribution, broadcast, cablecast, license, advertisement, exhibition.



Full Name: ______________________________________________________


Email: _________________________________________________________


Date: _____________________   Place (City/Town): ______________________


Signature: ______________________________________________________



Mailing List: –

[ ]  By checking this box, I grant permission to add my email to Bhangra dance mailing list.

PDF  : Click here to download a PDF version of this release form