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RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK; AND INDEMNITY AGREEMENT (“AGREEMENT”)
I represent that I understand the nature of this activity and that I am qualified, in good health and in proper physical condition to participate in such activity. I acknowledge that if I believe event conditions are unsafe or I am unable to safely perform any activity, I will immediately discontinue participation in the activity.
I fully acknowledge, understand, appreciate and agree, that this activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the Releasees named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, cost, and damages I incur as a result of my participation in the activity.
I further acknowledge, understand, appreciate and agree that my participation may result in possible exposure to and illness from infectious diseases, including, but not limited to, MRSA, Influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for my participation and exposure.
I hereby release, discharge, and covenant not to sue your business, it's administrators, directors, agents, officers, volunteers, employees, contractors, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of the premises on which the activity takes place, (each considered one of the “RELEASEES” herein) from all liability, claims, demands, losses, damages, on my account caused or alleged to be caused in whole or in party by the negligence of the RELEASEES or otherwise, including negligent rescue operations and further agree that if, despite this release, waiver of liability, and assumption of risk, I or anyone on my behalf, makes a claim against any of the RELEASEES, I will indemnify, defend, and hold harmless each of the RELEASEES from any loss, liability, damage, or cost, which any may incur as the result of such a claim.
I have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, and I understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law. I agree that if any portion of this Agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect.
Printed name of participant(s) _________________________________________________
PARENTAL CONSENT I, hereby covenant and promise that I am the minor’s parent and/or legal guardian, and on behalf of myself and the minor, understand the nature of the above referenced activities and the minor’s experience and capabilities and believe the minor to be qualified to participate in such activity. I further understand the risk of exposure to injury and/or infectious diseases, for myself and my child, as a participant, spectator at events, classes or our presence at the facility. I hereby release, discharge, covenant not to sue and AGREE TO DEFEND, INDEMNIFY AND HOLD HARMLESS each of the RELEASEES from all liability, claims, demands, losses or damages on the minor’s or my account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, including, but not limited to injury, negligent rescue operations, and/or exposure to infectious diseases and I further agree that if, despite this release, I, the minor, or anyone on the minor’s behalf makes a claim against any of the above RELEASEES, I WILL DEFEND, INDEMNIFY, AND HOLD HARMLESS each of the RELEASEES from any litigation expenses, attorney fees, loss liability, damage, or cost which any RELEASEE may incur as the result of any such claim.
Libra Dance Studio Release Form:
I hereby fully release, indemnify and hold harmless and defend Libra Dance Studio, LLC, its owners, members, advisors, Board of Directors, and all employees and agents from any and all liabilities, suits, claims from injuries, damage or loss which I (or dependents under 18 years of age) may have or which my accrue to me (or dependents) on account of my (their) participation in Libra Dance Studio LLC, activities whether on or off the premises. I further agree to indemnify and hold harmless and defend Libra Dance Studio LLC, its owners, members, advisors, Board of Directors, and all employees and agents from any and all claims resulting from injuries, damages and losses sustained by me (or dependents under 18 years of age) and arising out of, connected with, or in any way associated with these activities sponsored by Libra Dance Studio, LLC. I (or dependents) recognize that Libra Dance Studio, LLC. is not responsible for any lost or stolen property, at any time.
-I understand that this is not the full handbook. I agree to read the Handbook sent out via email.
-I understand there is a dress code that will be enforced.
-I understand that tuition must be paid a week in advanced. If the tuition is late then I agree to pay the $15 late fee.
-I understand that I will be notified via Email that the Libra Dance Studio is closed Due to bad weather. I understand that it will also be listed on the Libra Dance Studio Facebook Page and Instagram Page.
-I understand that I am not allowed to video tape during the Libra Dance Studio Recital.
-I understand that Libra Dance Studio will not order any costumes until they are paid for in full.
- I understand that my dancer will not be allowed to perform in the Libra Dance Studio 2020 Recital if their tuition is not up to date and paid for in full.
-I understand that there is a $15 fee for all costume fees handed in after the November due date.
-I understand that Libra Dance Studio will be placing my child according to their professional opinion and all class placements must be approved by the director.
-I understand that all monthly newsletters and memos will come via email. It is my responsibility to give any updated email address to the office.
-I understand that I am responsible for watching my child outside the assigned class time. This includes before and after class.
-I understand Libra Dance Studio’s Discipline Policy.
-I keep the waiting room a comfortable environment for all Libra Families. I will keep any children in the waiting under control and gossip free.
-I will speak directly to the Owner, Laura Giacomelli Huntowski, with any issues that may come up.
I read and understand the 2019-2020 INFORMATION AND POLICY OF LIBRA DANCE STUDIO.
Photo Permission Form
Libra Dance Studio LLC. Release
Of consideration of my engagement as a model, and for other good and valuable consideration herein acknowledged as received, I hereby grant to Libra Dance Studio LLC., his/her heirs legal representatives and assigns, those for whom Photographer is acting, and those acting with his authority, and permission the irrevocable and unrestricted right and permission to take, copyright in his own name or otherwise, and use, reuse and republish photographic portraits, video footage, or pictures of me or in which I may be included in whole or part, or composite or distorted in character or form without restriction as to changes or alterations, in conjunction with my own or a fictitious name, or reproductions thereof in color or otherwise, made through any medium at his studios or elsewhere, and in any or all media now or hereafter known for illustration, promotion, art editorial, advertising, trade, stock sales, or any other purpose whatsoever, without further compensation. I also consent to the use of any published matter in conjunction therewith.
I hereby waive any right that I may have to inspect or approve the finished product or products and the advertising copy or other matter that may be used in conjunction therewith or the use to which it may be applied.
I hereby release, discharge and release Libra Dance Studio LLC., his/her heirs, legal representatives and assigns, and all persons acting under his permission or authority or those for whom he is acting, from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of said photograph or in any subsequent processing thereof, as well as any publication thereof, including without limitations any claims for libel or invasion of privacy.
I hereby warrant that I am of legal age and have the right to contract in my name. I have read the above authorization, release, and agreement, prior to its execution, and am fully familiar with the contents thereof. This release shall be binding upon me and my heirs, legal representatives, and assigns.
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