Oct 01, 2023 01:03 PM

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 Dance City West, LLC has put in place preventative measures to reduce the
spread of the Coronavirus/COVID-19.
I further acknowledge that Dance City West, LLC 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, staff and other dancers and their families.
I voluntarily seek services provided by Dance City West, LLC 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 attending classes.
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, extreme headache, sore throat or new loss of
taste or smell.
I am following all CDC recommended guidelines as much as possible and limiting my exposure to the
I hereby release and agree to hold Dance City West, LLC harmless from, and waive on behave 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 Dance City West, LLC. I understand that this release discharges Dance City West,
LLC from any liability or claim that I, my dancer, or any personal representatives that may 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 Dance City West, LLC. This liability waiver and
release form extends to the studio together with all Owners and employees.