Ballroom Dance Club of Fairbanks
a great place to dance
In consideration of the right to participate in this activity, I waive and release any and all rights and claims for damage I may have against the Ballroom Dance Club of Fairbanks, its board, employees, instructors and agents, for any and all injuries suffered by me while participating in this activity unless such injury is caused by gross negligence.
I give my consent to emergency treatment, including hospitalization as may be needed for my welfare.
PO Box 81197
Fairbanks, AK 99708