JILL LANDRITH SCHOOL OF DANCE
Safety First Assumption of Risk Waiver
Due to the outbreak of the novel Coronavirus COVID-19, JLSD is taking extra precautions with the care of every student to include:
• MERV 13 air filters in the heating and air conditioning unit, MERV 13 air purifiers
• 6’ social distancing
• enhanced sanitation disinfection measures in accordance with state and local guidance
• Masks are required for all students over 5 years of age.
COVID-19 Student Liability Release Waiver
The CDC describes COVID-19 symptoms as fever or chills, cough, shortness of breath or difficulty breathing, fatigue, body aches, headaches, sore throat, congestion or runny nose, nausea, vomiting or diarrhea.
• I understand the symptoms
• I affirm that I and all of my household members DO NOT currently have the above symptoms nor have experienced these symptoms for the last 14 days.
• I affirm that I and all of my household members have NOT been diagnosed with COVID-19 within the past 30 days.
• I affirm that I and all of my household members have NOT been exposed to anyone diagnosed with COVID-19 within the past 30 days.
• I affirm that I and all of my household members have NOT traveled outside of the country or to any city considered a “hot spot” for the COVID-19 virus within the past 30 days.
• I understand that the Jill Landrith School of Dance, it’s owner, representatives and/or employees CANNOT be held liable for any exposure to the COVID-19 virus caused by misinformation on this form or the health history provided by each student.
I agree to each statement above and release Jill Landrith School of Dance, it’s owner, representatives and/or employees from any and all liability for the unintentional exposure or harm due to COVID-19.
RELEASE OF LIABILITY
READ CAREFULLY – THIS AFFECTS YOUR LEGAL RIGHTS
In exchange for participation in the activity of dance organized by Jill Landrith and The Jill Landrith School of Dance, facilities and services of Jill Landrith and all employees, representatives or agents, I agree for myself and (if applicable) for the members of my family, to the following:
1. I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by Jill Landrith , or the employees, representatives or agents of The Jill Landrith School of Dance.
2. I recognize that there are certain inherent risks associated with the described activity and I assume full responsibility for personal injury to myself and (if applicable) my family members, and further release and discharge Jill Landrith and all employees, representatives or agents for injury, loss or damage arising out of my or my family’s use of or presence upon the facilities of The Jill Landrith School of Dance, whether caused by the fault of myself, my family, Jill Landrith or other third parties.
3. I agree to indemnify and defend Jill Landrith, or the employees, representatives or agents of The Jill Landrith School of Dance against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs which may in any way arise from my or my family’s use of or presence upon the facilities of The Jill Landrith School of Dance.
4. I agree to pay for all damages to the facilities of The Jill Landrith School of Dance caused by my or my family’s negligent, reckless, or willful actions.
5. Any legal or equitable claim that may arise from participation in the above shall be my or my family’s responsibility. Neither I nor my family will hold Jill Landrith, or the employees, representatives or agents financially responsible for any such claim.
I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.
I agree to grant to Jill Landrith School of Dance and its authorized representatives permission to record on photography film and/or video, pictures of my participation. I further agree that any or all of the material photographed may be used, in any form, as part of any future publications, brochure, or other printed materials used to promote Jill Landrith School of Dance, and further that such use shall be without payment of fees, royalties, special credit or other compensation.
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