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Pop Dance LLC Waiver of Liability
Listed below is a copy of the Pop Dance Club Waiver. I acknowledge that I will also need to sign a hard copy of this when I arrive at the facility before myself or my child can participate in any activities, classes or lessons. By continuing and signing up online I am fully accepting this Waiver of Liability even without my signature present. I agree by completing the online registration my acceptance of this Waiver of Liability in full even without a hard copy signed.
(Parent/Guardian/Student) and, as applicable, acting as a parent, legal guardian, or custodian, on behalf of minor individual(s) (“Child” or “Children”) listed herein, for which I, the Undersigned, do hereby include as parties to this Waiver, intending them to be fully and legally bound by this Waiver, having the capacity and authority to agree to, acknowledge, consent, waive, and release of otherwise fully enter into this Waiver on their behalf as parent, legal guardian, or custodian:
Childs Name:__________________________________Age:______Date of Birth:__________
Childs Name:___________________________________Age:______Date of Birth:_________
Childs Name:___________________________________Age:______Date of Birth:_________
I (Parent/Guardian/Student) hereafter collectively referred to as the “Undersigned”, “I”, “Me”, “My”, “Mine”, or “Myself”), in consideration of the consent of the ownership and management of Pop Dance LLC, its directors, officers, employees, agents, representatives, related entities, owners, successors, and the assignees of Pop Dance LLC, and any other entities or persons located or operating therein, (hereinafter collectively referred to as “PD”), to My use of any facilities, property, or equipment on the premises or in possession of PD (“PD Property) installed at or in such facility (collectively, the “PD” Facilities), and to My participation in or observation of events or activities (hereinafter referred to as “PD Activities”), and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Undersigned, intending to be legally bound, for Myself, My heirs, assignees, executors, representatives, and administrators, does hereby acknowledge and do the following:
I, the Undersigned, voluntarily enter into this WAIVER OF LIABILITY AND GENERAL RELEASE (the “Waiver”), and do waive and release, assume all risks, and agree to indemnify and hold harmless PD, its directors, officers, employees, agents, representatives, related entities, owners, successors, and the assignees of PD from and against any and all claims for death, personal injuries, workers’ compensation, loss of property, property damage, and actions of any kind whatsoever, arising directly or indirectly out of or related to My use of or interaction with PD, PD Facilities and PD Property, or arising out of or related to My participation in or observation of PD Activities, including without limitation, liability arising out of any negligence, carelessness, action, omission, or conduct on the part of PD.
PD PROPERTY, PD FACILITIES, AND PD EQUIPMENT
I understand, acknowledge, and agree that I am not authorized to use any PD Facility or PD Property, unless I have been so advised and permitted to by PD, and have been advised sufficiently as to where I am and am not authorized to be. I also agree to comply with any verbal direction or instructions provided by PD as to such authorization, access, use, interaction, or observation.
Notwithstanding the aforementioned limitations, I understand and acknowledge that I may be asked to be an observer or limited participant within an area containing PD Property or a PD Facility which I am not permitted to use, but nevertheless may have need to be at or near, walk or stand on, touch, or interact with in order to comply with PD policies and procedures. I understand and acknowledge I am entirely voluntarily coming into contact with such property, equipment, or facility at My own risk. I further understand that PD is not and shall not be responsible for an injury that may occur due to My use or interaction with of the PD Facilities and PD Property. I further represent and warrant that I have sufficient health insurance to cover any and all injuries that I may sustain through use of or interaction with the PD Facilities or PD Property. I agree to be solely responsible for all such injuries, damages, loss, medical treatment, bills or otherwise that results from My use of or interaction with the PD Facilities and PD Property.
I acknowledge that I will use the PD Facilities and PD Property with reasonable and extraordinary care and take all precautions to minimize injury to Myself and others. I understand that it is My responsibility to immediately report any injury occurring as a result of the use of or interaction with the PD Facilities and PD Property to the PD. I shall also immediately report any problem, issue or dangerous condition existing or suspected of existing at the PD Facilities and PD Property. It is My responsibility to inspect all equipment or PD Property or PD Facility prior to use or interaction.
Additionally, I expressly waive any right or claim that I may have now or that may rise in the future, arising out of or related to My use of the PD Facilities and PD Property, including, but not limited to, claims for insurance benefits, workers’ compensation coverage, personal injuries, death, property damage or loss, negligence claims, breach of contract, breach of warranty, breach of covenants, and any representation or warranty, whether such is expressed or implied.
I acknowledge the availability of instructions on the proper use of all PD Property and PD Facilities and represent that I will either read such instructions or get instruction from a qualified person prior to My use of or interaction with any PD Facility and PD Property. I shall only use or interact with such that I have complete understanding of its proper use, safety features, potential hazards, and warnings, I will not use any PD Facility or PD Property that I am not familiar with or that appears to be in disrepair. I further acknowledge that I understand all of the risks associated with the use of the PD Facilities and PD Property and that I have received or been offered a copy of this Waiver and General Release. The use of PD Facilities and PD Property any and all equipment located therein is at my own risk and without liability to PD.
Further, if I choose to participate in any PD Activities, including but not limited to practices, trainings, conditionings, parties, games, dancing, performing, competitions, cleaning, meets, observation of such, or sponsored by or in conjunction with PD , I hereby waive and release, assume all risks, and agree to indemnify and hold harmless PD, its directors, officers, employees, agents, representatives, related entities, owners, successors, and the assignees of PD from and against any and all claims for death, personal injuries, workers’ compensation, loss of property, property damage, and actions of any kind whatsoever, arising directly or indirectly out of or related to My participation in such PD Activities, including without limitation liability arising out of any negligence, carelessness, action, omission, or conduct on the part of the PD.
Additionally, I expressly waive any right or claim that I may have now or that may arise in the future, arising out of or related to My participation in PD Activities, including but not limited to, claims for insurance benefits, workers’ compensation coverage, personal injuries, death, property damages or loss, negligence claims, breach of contract, breach of warranty, breach of covenants, and any representation or warranty, whether such is expressed or implied.
I understand and agree that I am expressively waiving any and all rights under Florida law, and the laws of any state or territory of the United States, that would prevent or attempt to limit the application and enforceability of this Waiver and General Release I am fully aware of all rights and remedies being released, as well as the potential claims and/or causes of action that I am waiving and releasing.
I acknowledge that I have read this Waiver and General Release in its entirety: I have had the opportunity to consult with My attorney to the extent I wish to do so: and I sign this Waiver and General Release willingly and with full knowledge and understanding of its legal effects, representing and acknowledging that I am of the age of majority, competent to understand this Waiver, and have the capacity as parent, legal guardian or custodian to enter into this Waiver on behalf of the minor(s) herein listed. By signing up online, even without my signature present, I am fully agreeing to all contents of POP Dance LLC Waiver and Liability release. By signing this waiver I also agree that Pop Dance LLC may have to add additional terms and policies from time to time and I accept those additional additions by signing below.
Parent/Guardian/Student Signature ___________________________________
Parent/Guardian/Student Name Printed ________________________________
Driver License or State ID# / Relationship to Child
(________)___________________ Cell Number
Home Phone Number:___________________________________________
Emergency Contact (Other than parent):___________________________
Relationship to Child: __________________________________________
Medical conditions, allergies: ____________________________________
How did you hear about Pop Dance? _____________________________
The undersigned further acknowledge and agree that Pop Dance LLC shall be granted specific permission to use the image and/or likeness of the aforementioned child for any purpose as deemed applicable by Pop Dance LLC, including photographs and/or videotape, and to further use said child’s name, face, likeness, voice, and appearance, in connection with exhibits, publicity, advertising, social media and promotional materials without reservation or limitation as to the duration of the consent.
I acknowledge and agree to the Waiver of Liability by enrolling online and consider this online signup as my signature for the Waiver or Liability for POP Dance LLC.
New Covid-19 Procedures & Safety Precautions
1. Cubbies will be outlined as every other cubby and no more than 3 students at a time in the cubby area. No lingering in area once dancer has what they need. Must go to designated spot on the dance floor.
2. Dancers must wait outside, or in car until designated class time. The teacher will open the door to let students in at precisely the start time of class.
*Note- Teachers will not go and search for students at their cars. We suggest waiting outside at least 3 minutes before class time to wait to be let in so the teacher can see you.
3. Please have each dancer provide their own yoga matt for stretching. This will allow the dancers to keep their stretching and spots on the floor at a socially safe distance.
4. No food, or snacks will be allowed in the dance room at this time. If the dancer feels the need for a snack they can go outside the studio to eat, however only during a designated quick break time or in between class. This may not permit the student to be late to the next class.
5. Each dancer must provide his or her own water bottle. Our water cooler will not be accessible at this time. No water bottles shall remain in the studio after classes. Each student must bring their water bottle home with them.
6. Our POP Staff has the right at anytime to ask a student to leave class if they see fit, due to health concerns for themselves and the other students in the class.
7. Masks are not required for our staff or your dancers. If your child chooses to wear a mask they may. We are not responsible for providing masks.
8. We ask that the dancers take extra safety precautions before walking into our studio. Practicing good hygiene set by the CDC. Dancers may be asked to wash their hands in between each class.
9. Each person that enters our studio will have their temperature taken by our new thermometer system. If your temperature is not at the normal level you will not be permitted in and asked to leave.
10. At POP we have taken extra precautions to keep our studio clean and safe from COVID-19. We have regularly scheduled cleanings, hand sanitizer, Lysol wipes, and disinfectant spray. After each night the studio will be wiped down and ready to go for the next day.
11. At this time we please ask that no parents or additional persons wait in the lobby area. We are trying to limit our capacity at this time.
If you have any questions or concerns we encourage you to please call and ask us. We are here to help make this experience for you and your dancer and our staff as smooth as possible.
Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the WorldHealth Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to- person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
POP Dance Club has put in place preventative measures to help reduce the spread of COVID- 19; however, the Studio, cannot guarantee that you or your dancer/child(ren) will not become infected with COVID-19. Further, attending POP Dance Club could increase your risk and your child(ren)s risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by being at POP Dance Club, and that such exposure of infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at POP Dance Club may result from the actions, omissions, or negligence of myself and others, including, but not limited to, POP Dance Club’s employees, owner, staff, volunteers, participants and their families.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)s attendance at POP Dance Club.
On my behalf, and behalf of my child(ren), I hereby release, covenant not to sue, discharge, and hold harmless the Studio, its employees, and representatives, or and from the claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of POP Dance Club, its employees, staff, owner, and volunteers, whether a COVID-19 infection occurs before, during, or after participation in any Studio activities.
Signature of Parent/Guardian
______________________________________________ Name of Dancer: ____________________________
Printed Name of Parent/Guardian
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