2021 WAIVER FORM


May 12, 2021 07:05 PM



ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM
SYNERGY DANCE AND FITNESS STUDIO

- Classes run in school terms. 4 terms a year with an end of year showcase, professional photo day and presentation night in December. You will need to inform reception in writing of not participating in these events by the first week of term 3. Failure to do so will result in full payment required of costumes for end of year shows.
- Once registered with Synergy Dance & Fitness Studio, I understand that my enrolment rolls over automatically each term. 2 weeks written paid notice must be given for cease of enrolment. Full payment of fees/outstanding fees are the sole responsibility of the persons who signed enrolment.
- Classes are non refundable though special exemptions are granted with medical certificates ie, Broken bones, hospital stays etc.
Late fees/Administrative fees will apply automatically to accounts which are not up to date by the end of each month.
- Correct attire and footwear must be worn to every class. This is essential to the safety and longevity of each student. Failure to have correct attire and footwear will result in no participation in activities.
a. Acro/Tumbling
I understand that Acro/Tumbling has a high risk of injury and I agree to ensure my child/s is only performing movements within their physical limitations. There are prerequisites needed to be in levelled classes depending on the Childs capabilities. I exempt, release, and indemnify Synergy Dance & Fitness studio, it’s owners, agents, volunteers, assistants, contractors, guest artists, faculty members, and/or students liable for any injury that may occur while taking Synergy Dance & Fitness Studios.

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN THIS ACTIVITY OR EVENT, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.

I certify that I/my child is physically fit, have sufficiently prepared or trained for participation in the activity or event, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity or event.

I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity or event in which I may participate, and that it will govern my actions and responsibilities at said activity or event.

In consideration of my application and permitting me to participate in classes, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:

I HEREBY WAIVE, RELEASE, AND DISCHARGE Synergy Dance a d Fitness Studio and all divisions thereof of any and all liability and responsibility for injuries, sickness, pandemics, accidents, natural disasters and/or acts of God incurred during participation in and/or instruction of camps, intensives, private instruction, choreography or any activity I may participate.

I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: Synergy Dance and Fitness Studio and/or their directors, officers, managers, employees, volunteers, representatives, and agents, the activity or event holders, activity or event sponsors, activity or event volunteers;

The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY, AN AGREEMENT AND I SIGN IT OF MY OWN FREE WILL.

PARENT / GUARDIAN WAIVER FOR MINORS (Only if student is under 18 years old)
The undersigned parent and natural guardian does hereby represent that he/she is, in fact, acting in such capacity, has consented to his/her child or ward’s participation in the activity or event, and has agreed individually and on behalf of the child or ward, to the terms of the accident waiver and release of liability set forth above. The undersigned parent or guardian further agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and the parents or legal guardian.