Submission of this form by the party listed above signifies the following statement: I, , agree to hold the organizers of this event, owners or lessors of the premises used for this event and their agents harmless from all suits, claims, or demands of every kind and character arising out of and in conjunction with this event. I hereby authorize the reproductions, sale, copyright, exhibition, broadcast, and/or distribution of any event videotape without limitations. I understand the physical risks of dance lessons and social dancing and assume full responsibility for any injury or personal damages resulting from the event named above.