HighJinx Auditons 2018
Name *
Name
Date of Birth *
Date of Birth
EMERGENCY CONTACT / GUARDIAN NAME
EMERGENCY CONTACT / GUARDIAN NAME
Participation Agreement *
The Dust Palace endeavors to create as safe an environment as is possible when training aerial circus skills; with a fully comprehensive risk management system, first aid training for staff, first aid onsite at all times and regularly checked equipment. 2. RULES AND REGULATIONS I understand that the rules and regulations given by The Dust Palace staff are important to ensure the safety of all participants, and must be respected. NOTE: (Should you at any time feel unsafe or compromised by the environment or actions of staff please speak with Eve Gordon 021822236) 3. Waiver of liability, release of all claims, risk assumptions and indemnification agreement. By signing this, you agree not to enter into legal proceedings and lawsuits with The Dust Palace Productions Ltd or any sub-contractor working for them. 4. Description of Risks: I ACKNOWLEDGE THAT THE FOLLOWING DESCRIBES SOME OF THE RISKS OF AERIAL AND ACROBATIC WORK AND THE USE OF ITS INFRASTRUCTURES. 1. Slips, trips, falls or painful crashes while using the facilities or aerial equipment, landing mats, floors below aerial equipment, bathroom facilities, and/or stairs; 2. Injuries resulting from falling, including but not limited to, falling onto persons, falling and coming into contact with any walls, structures or ropes, or falling to the floor. I understand that the description of these risks are not complete and that other unknown or unanticipated risks may result in injury, or death.