All participants and students must complete this form before participating in any classes or rehearsals at KM Dance Arts . If participant is under age 18, a parent or guardian must also sign this form.
Admission to class and/or rehearsal will not be granted if this form is not received prior to class and is not properly signed.
Waiver of Liability - By proceeding you recognize and understand the risks of physical injury inherent to dance and dance training and fully assume those risks. I hereby release The KM Dance Arts, its affiliates dance studios, event sponsors, employees and dance teachers from all liability for injuries sustained or illnesses contracted while attending or participating in any dance classes, rehearsals, workshops, or performances.
I agree to indemnify, defend, and hold harmless KM Dance Arts, its affiliate dance studios, event sponsors, employees and dance teachers for liabilities, costs and judgments arising from acts of omissions committed by me or my child which result in injury or damage to any person or property.
Protection of Property - I understand and agree that it is my sole responsibility to safeguard my personal property while attending or participating in any classes, rehearsals, workshops, or performances. I hereby release KM Dance Arts, its affiliate dance studios, event sponsors, employees and dance teachers from all liability for loss or damage to my personal property while attending or participating in classes, rehearsals, workshops, or performances. I also agree to abide by any rules, regulations and policies set forth by KM Dance Arts.
Medical Attention - In case of physical injury or medical emergency, I hereby authorize KM Dance Arts to make necessary arrangements to transport myself or my child to a medical treatment facility as necessary. All such transportation and medical treatment will be at my sole cost and expense. In extreme emergency, or if my child is under 18 years of age, I understand that KM Dance Arts will attempt to notify the person(s) I have named as my emergency contact(s) of my condition and how to reach me.
Photo Release – KM Dance Arts reserves the right to use photographs and videos taken during classes, workshops, performances, or other affiliated events for the purposes of instruction, advertising and promoting KM Dance Arts and its programs. Students, or parents of students who are minors, who do not wish to comply with this policy must notify KM Dance Arts prior to participation in class.
Acknowledgement of Waiver – I acknowledge and represent that I have fully informed myself of the content of the waiver and hold harmless agreement by reading it before I sign it, and I understand that I sign this document as my own free act and deed; no oral representations, statements, or inducements, apart from the written statement, have been made. I further state that I am at least eighteen (18) years of age and am fully competent to sign this agreement; and that I execute this release for full, adequate, and complete consideration fully intending to be bound by the same. I further state that there are no health-related reasons or problems which preclude or restrict my or my child’s participation in this activity, and that I will pay any medical costs that may be attendant as a result of injury to me or my child.
WAIVER AND RELEASE OF LIABILITY
In consideration of the risk of injury while participating in dance (whether joining online classes or in-person) (the “Activity”), and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the Activity, and do hereby release and forever discharge KM Dance Arts, located at 4615-4617 Manzanita Avenue, Carmichael, CA 95608, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity, including traveling to and from an event related to this Activity.
My child(ren) is/are voluntarily participating in the aforementioned activity and they are participating in the activity entirely at their own risk. I am aware of the risks associated with traveling to and from as well as participating in this activity, which may include, but are not limited to, physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability, economic or emotional loss, and death. I understand that these injuries or outcomes may arise from my own or others’ negligence, conditions related to travel, or the condition of the activity location(s). Nonetheless, I assume all related risks, both known or unknown to me, of my participation in this activity, including travel to, from and during this activity.
I understand that there are risks of physical injury associated with, arising out of, and inherent to dancing. These risks include the potential for slips and falls, sprains, strains, dislocations, soft tissue injuries, musculoskeletal injuries, podiatric conditions, and other risks not specified here.
Understanding these risks and the potential for others not listed, I agree to personally accept and assume all of the risks present in my participation at KM Dance Arts. My participation at KM Dance Arts is entirely voluntary, and I choose to participate in spite of the risks.
Dance education sometimes requires hands-on instruction as well as verbal instruction. Instructors may correct dancers by touching their arms, legs, feet, hips, back and head to move them in the correct position. Dancers will also need to be spotted for safety during challenging skills. I acknowledge that this is a common standard in dance instruction and understand that it is my responsibility to communicate clearly with the dance teacher and/or the director if any form of touch is unacceptable to me.
The novel 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. KM Dance Arts has put in place preventative measures to reduce the spread of COVID-19; however, KM Dance Arts cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending KM Dance Arts could increase your risk and your child(ren)’s risk of contracting COVID-19.
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 attending KM Dance Arts and that such exposure or 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 KM Dance Arts may result from the actions, omissions, or negligence of myself and others, including, but not limited to, KM Dance Arts employees, volunteers, and program participants and their families.
MEDICAL TREATMENT AND INSURANCE
I understand that KM Dance Arts does not assume any responsibility for or obligation to provide financial or other assistance in the event of injury or illness, including but not limited to medical, health, or disability insurance or support.
I authorize KM Dance Arts to obtain necessary medical or dental treatment, including first aid, ambulance transport, hospitalization, or such other care necessary for your child(ren’s) health and welfare in an emergency. If your insurance does not cover emergency treatment that is deemed necessary and sought for your child(ren) by KM Dance Arts, I agree to be responsible for and pay all costs incurred on my behalf.
I release and discharge KM Dance Arts from any claim which may arise on account of any first aid, treatment, or service rendered in connection with your child(ren’s) participation in KM Dance Arts activities or with the decision by any representative or agent of KM Dance Arts to consent to medical or dental treatment on your behalf in an emergency. I understand that KM Dance Arts does not carry or maintain health, medical, dental, or disability insurance coverage for any participant. I agree to take responsibility for full payment of any emergency medical or dental costs related to my KM Dance Arts participation regardless of whether I have insurance coverage.
I understand that KM Dance Arts may take photo and video recordings of my child(ren) during their participation in KM Dance Arts classes and activities. I convey to KM Dance Arts full rights
and interest in these recordings. I understand such recordings may be used in advertising or other published materials, physical or virtual.
If I do NOT consent to my child(ren) being photographed or video-recorded, I will make sure the director is aware of my concerns and the reasons for them. I will advise my child(ren) to be proactive about avoiding being photographed or recorded, and I will hold KM Dance Arts harmless if a photo or video recording of my child(ren) is released despite all precautions. I understand that this choice may limit my participation in performances that are routinely photographed and/or videotaped.
While a participant at KM Dance Arts, I agree that my child(ren) will abide by any rules, codes, and policies that are put in place by KM Dance Arts before or at any time during my participation. If I have questions or concerns regarding any policies or decisions made by any representative of KM Dance Arts, I agree to bring them promptly and specifically to the director’s attention.
All participants must sign a Signature Page at the start of each dance year certifying that they have read this document, understand it in its entirety, and agree to be bound by its terms, before participating in classes and/or activities
Powered by: DanceStudio-Pro.com