DANCE FOR PD®    ~   Registration,  Waiver, and Release

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Select all that apply.
* For Garfield Community Center Classes:
In addition to your registration with STG, you will also need to register for class with Seattle Parks and Recreation. This can easily be done by calling Angela Smith at Garfield Community Center at 206-450-9522. 

I recognize that risk of illness and/or injury may be inherent in any dance or exercise class; however, the above identified individual is participating with the express agreement of, and understanding that Seattle Theatre Group, Northwest Parkinsons Foundation, Dance for PD®, Mark Morris Dance Group, and Pacific Northwest Ballet-Francia Russell Center, and its directors, officers, employees, partners and agents are hereby released from any and all claims, costs, liabilities, expenses, or judgments associated with this Dance for Parkinsons program. I hereby execute and deliver this Waiver and Release form to induce SEATTLE DANCE FOR PD® PARTNERS to permit the above identified student to participate in the Dance for Parkinsons in the 2021-2022 year.


I hereby understand that SEATTLE DANCE FOR PD® PARTNERS may take photographs and/or video of the participants enrolled on this form, and I authorize SEATTLE DANCE FOR PD® PARTNERS to use these photographs and video for archival and marketing purposes via brochures, website, and social media. 

Please note that to attend in-person Dance for PD® classes, proof of COVID 19 vaccination will be required. If a student does not have a COVID 19 vaccination due to personal reasons, they will be required to show proof of a negative COVID 19 test within 48 hours of each class. Further, we will be requiring that all students and staff wear masks during class.

I hereby grant the SEATTLE DANCE FOR PD® PARTNERS staff permission to administer first aid and/or call 911 in the case of a medical emergency while I attend classes. I realize and understand that SEATTLE DANCE FOR PD® PARTNERS staff will attempt to notify emergency contacts in case of an emergency.

In Witness Whereof, I have executed this waiver and release.

Participant Information

Emergency Contact

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