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EMERGENCY MEDICAL RELEASE AND LIABILITY WAIVER

I, the undersigned PARTICIPANT (“PARTICIPANT”) with ROSEWOOD THEATRE, acknowledge and

fully understand that the PARTICIPANT will engage in activities that involve risk of serious injury, including

permanent disability or death, which might result not only from the PARTICIPANT’s action, inaction, or

negligence, but also the action, inaction, or negligence of others and/or the condition of any premises and

hazards of travel by air, train, bus, automobile, and other means, including but not limited to walking

and/or driving or being driven to and from rehearsals, performances, and other activities, and furthermore,

that there may be other unknown risks that are not reasonably foreseeable at this time.

Accordingly, I acknowledge, fully understand, and agree that I assume all the foregoing risk and accept

personal responsibility for the damages following such injury, permanent disability, or death, and hereby

release, discharge, covenant to indemnify and not sue ROSEWOOD THEATRE, its instructors,

managers, employees, and associated personnel, officers, directors, agents, members, volunteers, and

representatives from any and all liability to PARTICIPANT, his/her heirs and next of kin, against any and

all claims by or on behalf of PARTICIPANT as a result of my participation in, at, or for ROSEWOOD

THEATRE.

In the event of my illness or injury, I hereby authorize any of the directors, officers, managers, producers,

instructors, or chaperones of ROSEWOOD THEATRE who are present to consent to whatever x-ray

exam, anesthetic, medical, surgical, or dental diagnosis, treatment, and/or hospital care considered

necessary for PARTICIPANT in the reasonable judgment of the attending physician, surgeon, or dentist

and to be performed by or under the supervision of a member of the medical staff of the hospital or facility

furnishing such medical or dental services. I agree to be financially responsible for the cost of such

assistance and/or treatment. I recognize and agree that the directors, officers, managers, instructors, or

chaperones of ROSEWOOD THEATRE consenting to such health care may reasonably and in good faith

rely upon the advice furnished to him or her by the attending licensed health care provider(s).

I have read the above waiver/release and understand that I have given up substantial rights by signing

this release and sign below voluntarily. I understand that this document may not be altered in any manner

without the express written consent of the director of ROSEWOOD THEATRE and that any unauthorized

alteration will cause the PARTICIPANT to be removed from ROSEWOOD THEATRE.

NOTICE: This authorization for emergency medical treatment must be completed before the

performer may participate in any activities with, at, or for ROSEWOOD THEATRE. Treatment for injury will be based upon information provided herein.