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Upon registration, I as a parent or Guardian of the student at Visceral Dance Center(VDC), do hereby fully release and discharge VDC, their officers, faculty, and employees from any and all claims from injuries, damage, or loss which may incur on account of my child's participation in class. I understand that any pictures taken become property of VDC and may be used in future advertising, online and in print. I also understand that there is a no refund policy unless the class has been cancelled by Visceral Dance Center. I understand that there is a $25 late fee on any payments that are declined or not payed by the due date. I also understand that there is a $50 withdrawal fee.
VISCERAL DANCE CENTER CONSENT FORM, WAIVER OF LIABILITY AND ASSUMPTION OF RISK DUE TO THE COVID-19 PANDEMIC
I, by checking this box, voluntarily consent to receive dance instruction during the COVID-19 pandemic. I acknowledge for myself (or as parent/guardian) that I am fully aware of the risks to personal health from COVID- 19. I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. I understand that Visceral Dance Center is following Centers for Disease Control (“CDC”) guidance to protect its dancers and staff including all employees, independent contractors, work study students and volunteers. I confirm that I am not presenting any of the following symptoms of COVID-19 listed below:
Fever or chills
Shortness of Breath or Difficulty Breathing
Loss of Sense of Taste or Smell
Runny Nose or Congestion
Muscle or Body Aches
Nausea or Vomiting/Diarrhea
I HAVE CAREFULLY READ AND VOLUNTARILY AGREE TO THIS CONSENT FORM, WAIVER OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT AND FURTHER AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THIS WRITTEN AGREEMENT HAVE BEEN MADE. I AM AWARE THAT I AM GIVING UP LEGAL RIGHTS, INCLUDING THE RIGHT TO RECOVER DAMAGES FROM VISCERAL DANCE CENTER IN THE EVENT OF ILLNESS, INJURY, DEATH OR PROPERTY LOSS OR DAMAGE DUE DIRECTLY OR INDIRECTLY TO EXPOSURE TO COVID-19.
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