Liability Release Form:
I understand that there are risks of physical injury associated with, arising out of, and inherent to the activity of
dance. In recognition of the acknowledgement risk of injury, I knowingly and voluntarily waive all rights and/
or causes of action of any kind, including all claims of negligence arising as a result of such activity from which
liability could accrue to Tippy Toes Dance Studio, Inc, its' members, officers, agents, employees, instructors,
assistants, subsidiaries and all affiliated entities (hereinafter collectively referred to as Tippy Toes Dance
Studio).
The noel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health 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.
Tippy Toes Dance Studio has put in place preventative measures to reduce the spread of COVID-19 and other
communicable diseases; however, Tippy Toes Dance Studio cannot guarantee that you or your child(ren)
will not become infected with COVID-19 or any other communicable disease. Further, attending
Tippy Toes Dance Studio could increase your risk and your child(ren)'s rist of contracting COVID-19 and any
other communicable disease.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and any other communicable
disease and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19
or any other communicable disease attending Tippy Toes Dance Studio and that such exposure or infection
may result in personal injury, illness, permanent disability or death. I understand that the risk of becoming
exposed to or infected by COVID-19 or any other communicable disease at Tippy Toes Dance Studio may
result from the actions, omissions, or negligence of myself and others, including, but not limited to, Tippy
Toes Dance Studio employees, volunteers, and program 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, or any kind, that I or my child(ren) may experience or incur in connection with my child
(ren)'s attendance at Tippy Toes Dance Studio or participation in Tippy Toes Dance Studio programming.
(Claims) On my behalf, and on behalf of my child (ren) , I hereby release, covenant not to sue, discharge, and
hold harmless Tippy Toes Dance Studio, its employees, agents, and representatives, of 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 neglegence of
Tippy Toes Dance Studio, its employees, agents, and representatives, whether a COVID-19 or any other
communicable disease infection occurs before, during, or after participation in any Tippy Toes Dance Studio
program.
I hereby agree to release Tippy Toes Dance Studio and hold Tippy Toes Dance Studio harmless of all liability,
and hereby acknowledge and I knowingly assume full responsibility for all risks of physical injury arising out of
active participation in dance on behalf of the participants.
I am aware that this is a release of liability and an acknowledgement of my voluntary and knowing
assumption of the risk of injury. I have signed this document voluntarily and of my own free will in exchange
for the privilege of participation.
I also give Tippy Toes Dance Studio permission to use my child's picture in or on any form of advertisement for
Tippy Toes Dance Studio or a Tippy Toes Dance Studio affiliated event.
If I am a minor, my parent and/or legal guardian has also signed this document releasing Tippy Toes Dance
Studio from any and all such liability described above and has acknowledged that I am knowingly and
voluntarily assuming all risks of injury inherent to this activity.
The participant has my permission to participate in Tippy Toes Dance Studio events and activities. I warrant
that the below information is complete and correct, I further release Tippy Toes Dance Studio of all
liabilities associated with my child's attendance at Tippy Toes Dance Studio.