RELEASE AND WAIVER OF LIABILITY
Participant desires to participate in certain dance classes and activities of Mazza-Smith Dance, Inc. (or "Mazza Smith Dance") and assures that Participant is in proper physical condition to take part in dance classes and activities. Participant understands that there are risks of physical injury associated with, arising out of, and inherent to dancing and activities associated therewith. In recognition of this acknowledged risk of injury, and in consideration of being accepted into such dance classes or activities Participant hereby freely, voluntarily and without duress executes this release and waiver of liability under the following terms:
1. RELEASE AND WAIVER. Participant does hereby release and forever discharge and hold harmless Mazza-Smith Dance, Inc., its Members, employees and agents for any and all claims or demands for damages, loss of services, costs and expenses in any way resulting from any and all injury to Participant or property of Participant arising directly or indirectly out of Participant’s participation in any and all activities of Mazza-Smith Dance, Inc. Including, but not limited to, dance classes, competitions, travel to and from competitions , and any and all activities associated or performed in conjunction with Mazza-Smith Dance, Inc.
Participant understands that this Release discharges Mazza-Smith Dance, Inc. from any liability or claim that the Participant may have against Mazza-Smith Dance, Inc. with respect to any bodily injury, personal injury, illness, death, or property loss or damage that may result from Participant’s activities with Mazza-Smith Dance, Inc., whether caused by the negligence of Mazza-Smith Dance, Inc. or its Members, employees, agents or otherwise. Participant also understands that Mazza-Smith Dance, Inc. does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to, medical, health, or disability insurance in the event of injury or illness.
2. INDEMNIFICATION. Participant agrees to indemnify and hold forever harmless Mazza-Smith Dance, Inc., its Members, employees and agents from any and all injuries, damages, costs and attorney’s fees whatsoever which may arise out of the Participant’s participation in any Mazza-Smith Dance, Inc. activity or presence on the premises of the dance studio or satellite location.
3. INSURANCE. Participant understands that Mazza-Smith Dance, Inc. does not carry or maintain health, medical or disability insurance coverage for any participant. Participant understands that it shall be Participant’s sole responsibility to obtain his or her own medical or health insurance coverage for Participant.
4. PHOTO AND VIDEO RELEASE. Participant does hereby grant and convey unto Mazza-Smith Dance, Inc. all right, title and interest in any and all photographic images and video or audio recordings made by Mazza-Smith Dance, Inc. during Participant’s participation of any activities and may use these for advertising purposes.
5. MISCELLANEOUS. This Release and Waiver of Liability shall be binding on the heirs, successors and personal representatives of the Participant. Participant expressly agrees that this Release and Waiver of Liability is intended to be as broad and inclusive as permitted by the laws of the State of Florida, and that this Release and Waiver of Liability shall be governed by and interpreted in accordance with the laws of the State of Florida
6. MINORS. If Participant is a minor, the parent having legal custody and/or the legal guardian of the minor hereby represents and warrants that they have the legal authority to bind the Participant and such parent or guardian executes this release on behalf of the minor and the parent or guardian, and this release is binding on the child and such parent or guardian.
7. COVID-19 PANDEMIC. I knowingly & willingly consent to return to Mazza-Smith Dance, Inc. premises during the COVID-19 Pandemic. I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be contagious. It is impossible to determine who has it and who does not; given the current limits in virus testing.
Standard precautions reduce risk as much as possible, but this is how the virus could be spread. A weak or compromised immune system (including, but not limited to, conditions like diabetes, asthma, COPD, cancer treatment radiation, chemotherapy and any prior or current disease or medical condition), can put you at greater risk for contracting COVID-19.
8. COVID-19 DISCLOSURE. Please disclose any indication of having been exposed to COVID-19, or whether you have experienced any signs or symptoms associated with the COVID-19 virus. If you have been exposed or could potentially be a carrier, please stay home for everyone's safety.
By coming to the Mazza-Smith Dance, Inc. premises, the undersigned agrees to the following:
I do not have a temperature 100.4 or greater. *
I do not experience shortness of breath or had trouble breathing. *
I do not have a dry cough. *
I do not a sore throat. *
I have not been in contact with someone who has tested positive for COVID-19. *
I have not tested positive for COVID-19. *
I have not been tested for COVID-19 and are awaiting results. *
I have not traveled outside the United States by air or cruise ship in the past 14 days. *
I have not traveled within the United States by air, bus or train within the past 14 days. *
I understand that due to frequency of visits of other customer visits at the studio, the characteristics of the virus, and the, that I have an elevated risk of contracting the virus simply by being in the studio.*
I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus. The CDC recommends social distancing of at least 6 feet for a period of 14 days to anyone who has. *
I understand that I will contact the studio if I develop any COVID-19 symptoms within the next 14 days. *
WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT
The undersigned, on behalf of himself or herself and such participating children and any personal representatives, heirs, and next of kin (hereinafter referred to as "the undersigned") hereby acknowledges, agrees and represents that he or she has inspected and carefully considered such premises, equipment and facilities and/or the affiliated program and that the undersigned finds and accepts same as being safe and reasonably suited for the use or participation by the undersigned and such participating children.
In addition, the undersigned acknowledges that novel coronavirus ("COVID-19") infections have been confirmed throughout the United States, including Duval County and the State of Florida.
In accordance with the most recent guidance and protocols issued by the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), the Florida Department of Health (FDH), for slowing the transmission of COVID-19, the undersigned hereby agrees, represents and warrants that neither the undersigned nor such participating children shall visit or utilize the facilities, services, and programs of Mazza-Smith Dance, Inc. (other than any exclusively online services and programs) within 14 days after (i) returning from highly impacted areas subject to a CDC Level 3 Travel Health Notice, (ii) exposure to any person returning from areas subject to a CDC Level 3 Travel Health Notice, or (iii) exposure to any person who has a suspected or confirmed case of COVID-19. The CDC Travel Health Network is continuously updating this list and the undersigned agrees that they are aware of this list and the countries listed.
The undersigned agrees to check the CDC Travel Health Notices list (https://www.cdc.gov/coronavirus/2019-ncov/index.html) prior to utilizing the facilities, services and programs of Mazza-Smith Dance, on a daily basis if necessary.
Coronavirus disease 2019 (COVID-19) is a virus (more specifically, a coronavirus) identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China.
The undersigned hereby agrees, represents and warrants that neither the undersigned nor such participating children shall visit or utilize the facilities, services, and programs of Mazza-Smith Dance, Inc. if he or she (i) experiences symptoms of COVID-19, including, without limitation, fever, cough or shortness of breath or (ii) has a suspected or diagnosed/confirmed case of COVID-19.
The undersigned agrees to notify Mazza-Smith Dance, Inc. immediately if he or she believes that any of the foregoing access/use restrictions may apply.
Mazza-Smith Dance, Inc. has taken certain steps to implement recommended guidance and protocols issued by the Public Health Agencies for slowing the transmission of COVID-19, including, without limitation, the access/use restrictions set forth above.
The undersigned acknowledges and agrees that Mazza-Smith Dance, Inc. may revise its procedures at any time based on updated recommended guidance and protocols issued by the Public Health Agencies and further, agrees to comply with Mazza-Smith Dance Inc.'s revised procedures prior to utilizing the facilities, services, and programs of Mazza-Smith Dance, Inc.
The undersigned fully understands and appreciates both the known and potential dangers of utilizing the studio, services, and programs of Mazza-Smith Dance, Inc. and acknowledges that use thereof by the undersigned and/or such participating children may, despite the Mazza-Smith Dance Inc.'s reasonable efforts to mitigate such dangers, result in exposure to COVID-19, which could result in quarantine requirements, serious illness, disability, and/or death.
By signing below, I AGREE THAT IN FURTHER CONSIDERATION OF BEING PERMITTED TO ENTER MAZZA-SMITH DANCE FOR ANY PURPOSE INCLUDING, BUT NOT LIMITED TO, OBSERVATION OR USE OF FACILITIES OR EQUIPMENT, OR PARTICIPATION IN ANY ON-SITE OR OFF-SITE PROGRAM AFFILIATED WITH MAZZA-SMITH DANCE, INC., THE UNDERSIGNED HEREBY AGREES TO THE FOLLOWING:
THE UNDERSIGNED, ON HIS OR HER BEHALF AND ON BEHALF OF SUCH PARTICIPATING CHILDREN, FAMILY, SPOUSE, ESTATE, EXECUTORS, ASSIGNS, HEREBY RELEASES, PERSONAL REPRESENTATIVES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE Mazza-Smith Dance, Inc., its directors, affiliates, officers, volunteers, agents, employees and owner from all liability to the undersigned or such participating children and all personal representatives, assigns, heirs and next of kin of the undersigned or such participating children for any loss or damage, and any claim or demands on account of any property damage or any injury to, or an illness or the death of, the undersigned or such participating children (or any person who may contract COVID-19, directly or indirectly, from the undersigned or such participating children) whether caused by the negligence, active or passive, of the Mazza-Smith Dance, Inc. or otherwise while the undersigned or such participating children are in, upon, or about the premises or any facilities or equipment therein or participating in any program affiliated with Mazza-Smith Dance, Inc.
The undersigned AGREES TO INDEMNIFY AND SAVE AND HOLD HARMLESS Mazza-Smith Dance, Inc., its directors, officers, employees, volunteers and agents, and each of them, from any loss, liability, damages or costs they may incur, whether caused by the negligence, active or passive, or otherwise while the undersigned or any participating child is in, upon, or about the premises or any facilities or equipment therein or participating in any program affiliated with Mazza-Smith Dance, Inc.
The undersigned understands and agrees that Mazza-Smith Dance, Inc. is
not required to provide insurance to cover the undersigned or such participating children in the event they suffer an illness, injury, death, property loss, theft or damage of any sort upon, or about the premises or any facilities or equipment therein or participating in any program affiliated with Mazza-Smith Dance, Inc.
The undersigned understands and agrees to defend Mazza-Smith Dance, Inc. from and against any and all costs, expenses, damages, claims, lawsuits, judgments, losses, and/or liabilities arising either directly or indirectly from or related to any and all claims made by or against any of the Released Pares due to bodily injury, death, loss of use, monetary loss, or any other injury from or related to my use of The undersigned understands and agrees space, supplies, tools, equipment and/or materials, whether caused by the negligence of the Released Pares or otherwise specifically related to COVID-19.
The undersigned agrees and acknowledges that use of the Mazza-Smith Dance Inc. facilities and services, and participation in the Mazza-Smith Dance Inc. programs, may involve inherent danger and risk, including, without limitation, the risk of physical illness or injury, death or property damage.
THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR, AND RISK OF ILLNESS, BODILY INJURY, DEATH OR PROPERTY DAMAGE to the undersigned or such participating children due to negligence, active or passive, or otherwise while in, about or upon the premises of Mazza-Smith Dance Inc. and/or while using the premises or any facilities or equipment thereon or participating in any program affiliated with Mazza-Smith Dance, Inc. The undersigned acknowledges that any illness or injuries that the undersigned or such participating children contract or sustain may be compounded by negligent first aid or emergency response of the Release and waive any claim in respect thereof.
The undersigned AGREES THAT THE FOREGOING ASSUMPTION OF RISK, RELEASE, AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT is intended to be as broad and inclusive as is permitted by the laws of the State of Florida and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
ELECTRONIC CONSENT
The undersigned has CAREFULLY READ AND VOLUNTARILY SIGN THIS ASSUMPTION OF RISK, RELEASE, AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT AND FURTHER AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE. I AM AWARE THAT BY AGREEING TO THIS AGREEMENT I AM GIVING UP VALUABLE LEGAL RIGHTS, INCLUDING THE RIGHT TO RECOVER DAMAGES FROM MAZZA-SMITH DANCE, INC. IN CASE OF ILLNESS, INJURY, DEATH OR PROPERTY LOSS OR DAMAGE, INCLUDING, FOR THE AVOIDANCE OF DOUBT AND WITHOUT LIMITATION, EXPOSURE TO COVID-19 AT ANY MAZZA-SMITH, INC. PREMISE AND ANY ILLNESS, INJURY OR DEATH RESULTING THEREFROM. I UNDERSTAND THAT THIS DOCUMENT IS A PROMISE NOT TO SUE AND A RELEASE OF AND INDEMNIFICATION FOR ALL CLAIMS. IF SIGNING ON BEHALF OF MINOR: I ALSO UNDERSTAND THAT THIS AGREEMENT IS MADE ON BEHALF OF MY MINOR CHILDREN) AND/OR LEGAL WARDS AND I REPRESENT AND WARRANT TO MAZZA-SMITH DANCE, INC. THAT I HAVE FULL AUTHORITY TO SIGN THIS AGREEMENT ON BEHALF OF SUCH MINOR(S).
The undersigned has READ THE TERMS AND THIS ASSUMPTIONS AND RISK, RELEASE AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT AND AGREE TO ITS TERMS.