WAIVER, RELEASE AND INDEMNIFICATION STATEMENT 
In consideration for allowing my participation in ART IN MOTION PRODUCTIONS Rehearsals and events on campus SEPTEMBER   , 20   – MAY   , 20    (“ AIM”) at Barry University, Inc. (“BU”), I agree to the following: 
1. To comply with all the rules and regulations and AIM related instructions of BU and its Directors. 

2. For myself, my executors, administrators, heirs, next of kin, successors and assigns, 
I hereby: (a) waive and release any and all claims I may have against BARRY UNIVERSITY, Inc., its officers, trustees, employees, students, AIM event committee, volunteers, agents, sponsors, or any one or more of them or their executors, administrators, heirs, next of kin, successors or assigns (hereinafter collectively all of these parties are referred to as “BU”) including any and all claims for damage caused by negligence of any of them, arising out of my participation in AIM and its related activities, together with any cost including attorney's fees that may be incurred as a result of any such claim whether valid or not, and (b) indemnify and hold harmless the release of them against any such claim that I or my guests or any one or more of my or their executors, administrators, heirs, next of kin, successors or assigns may have or assert and against any costs including attorney’s fees with respects hereto. 

3. I hereby acknowledge that I have sole responsibility for my person possessions during the AIM event, and its related activities. 

4. I hereby acknowledge that participation in AIM may include but not limited to participating AIM’s weekly rehearsals, special events, concerts, volunteer work and performances,  which will carry potential hazards or injuries, to include, but not limited to: death, fatigue, minor or conditional pain and/or any additional grievances associated with dance or a result of the exercises. I, therefore, release BU from responsibility of any injury or death while I participate in AIM and/or its related activities (related activities include pre and post related activities with BU). I specifically release BU from any and all claims I may have against BU for damage caused by BU’s negligence arising out of my participation in the event and its related activities. 

5. I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident and/or illness during the AIM academic season.
 
6. I hereby approve the free use of my name and picture in broadcast, telecasts, and the press as they pertain to Art In Motion Productions. 

7. My signature below affirms that I have read, understand, and agree to all the provisions contained in this document. 

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Printed Name of Participant 		Signature of Participant 				Date

FOR MINOR PARTICIPANTS (UNDER AGE 18 AT THE TIME OF 9/1/2011) 
This is to certify that I, as parent/guardian with legal responsibility for the participant identifies below, for me, my spouse, my heirs, assigns and next of kin, have read and do consent and agree to his/her release, as provided above, of BU and hereby release the same. Further, I, for myself, my spouse, my heirs, assigns and next of kin agree to indemnify and hold harmless BU from any and all liabilities incident to my minor child’s involvement or participation in the as provided above EVEN IF ARISING FROM THE NEGLIGENCE OF BU or otherwise, to the fullest extent permitted by law. Further I understand and agree that this waiver, release and indemnity applies to the and its related activities (related activities include pre and post related activities with BU). 
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Parent/Guardian’s Signature					 Date Signed 

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Emergency Phone Number(s) 					Printed Name of Minor Participant