We need you to answer this to make sure you are a person and not spam.
I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.
I further acknowledge that Waconia Center for Dance Arts, LLC (afterward referred to as WCDA) has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.
I further acknowledge that WCDA can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, studio staff, and other studio clients and their families.
I voluntarily seek services provided by WCDA and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while present at the dance studio.
I attest that:
* I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
* I have not traveled internationally within the last 14 days.
* I have not traveled to a highly impacted area within the United States of America in the last 14 days.
* I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
* I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities.
* I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.
I hereby release and agree to hold Waconia Center for Dance Arts LLC harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the studio, or that may otherwise arise in any way in connection with any services received from WCDA. I understand that this release discharges WCDA from any liability or claim that I, my heirs, or any personal representatives may have against the studio with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from WCDA. This liability waiver and release extends to the studio together with all owners, partners, and employees.
I have chosen to have my child participate in dance instruction given by Waconia Center for Dance Art's dance studio (afterward referred to as WCDA). I acknowledge that I understand the nature of the activities my child will be participating in and that my child is in the proper physical condition and capable of participating in the related activities, understanding that WCDA is not in any way responsible for making such a determination.
In consideration of my child’s enrollment in any dance instruction program, I understand and agree on behalf of myself and my child, to release, hold harmless, and discharge WCDA from all claims, costs, liabilities, expenses or judgments, including attorneys’ fees and court costs for any occurrences in connection with any dance instruction. I assume all risks to my child in connection with any instruction and further release WCDA and its owner and staff from liability for any injury sustained by my child while he or she is enrolled in any dance instruction program, including all risks reasonably connected with such activity whether foreseen or unforeseen.
I understand that WCDA is not responsible for my child or other children under my supervision who are left unsupervised in the common areas and areas surrounding the dance studio and that WCDA will only be supervising my child when he or she is participating in scheduled dance activities, programs or instruction.
I understand that WCDA is not responsible for personal property that is lost, damaged or stolen while I or my child is at or on WCDA property.
I acknowledge and agree that it is my responsibility to maintain my own accident and health insurance coverage that provides adequate coverage for myself and my child participating in WCDA's activities and that WCDA does not provide accident or health insurance for those participating in its instruction, activities or programs.
Agreement of Classroom Protocol: I understand that the accepted practice and methodology of professional dance training entails “hands on” and other forms of physical contact with instructors and other students, and that this is necessary for a student to learn at an appropriate pace. I understand that if there is currently, or ever would be, any reason why I should not be touched, or should only be touched in a specific way, that it is my responsibility to inform EACH instructor as to what is acceptable, and to discuss any related physical or mental issues with them.
I HAVE FULLY INFORMED MYSELF AS TO THE CONTENTS OF THIS RELEASE AND HAVE READ THE SAME PRIOR TO AGREEING.
I hereby give permission for images of my child, captured during dance classes, dance rehearsals, dance performances and general studio events through video, photo and digital camera, to be used solely for the purposes of Waconia Center for Dance Art's promotional material and publications, and waive any rights of compensation or ownership thereto.
Powered by: DanceStudio-Pro.com