Covid-19 Release
WAIVER/RELEASE FOR COMMUNICABLE DISEASES INCLUDING COVID-19
In consideration of being allowed to participate in classes and other programs at Dianne Durkin Dance Studio, LLC ("DDDS"), I acknowledge and agree that:
1. Participation in classes and programs at DDDS includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While adherence to particular rules and practices and personal discipline may reduce this risk, the risk of serious illness and death does exist.
2. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the Releasees or others and assume full responsibility for my/ my child's participation.
3. I/my child willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I/my child observes and any unusual or significant hazard during my/my child's presence or participation, I/my child will stop participating and immediately bring the issue to the attention of the nearest dance teacher, owner, member or employee of DDDS.
4. I, for myself/my child and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and hold harmless DDDS, its officers, officials, agents, members and/or employees or independent contractors ("Releasees"), with respect to any and all illness, disability, death, or loss or damage to person or property, whether arising from the negligence of releasees or otherwise, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
FOR PARTICIPANTS UNDER THE AGE OF 18 YEARS:
This is to certify that I, as parent/guardian, with legal responsibility for this Participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and their personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to their release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child's/ward's presence or participation in these activities as provided above, even if arising from their negligence, to the fullest extent provided by law.
I acknowledge and agree that I am the parent or legal guardian of the Participant and have full authority, by law, to execute this Release.
Liability Agreement
-I, THE UNDERSIGNED PARENT AND/ OR GUARDIAN, understand that the risk of injury is inherent in any
physical activity, and I, on behalf of myself and my child, knowingly and voluntarily accept that risk. I, the
undersigned, for myself, my heirs, executors and administrators, hereby waive and release Cynthia Hixson,
individually, and Dianna Durkin Dance Studio and its staff from any and all damages of any kind arising out of my child's
participation in the dance program/performances at/with Dianna Durkin Dance Studio. I further certify that the aforementioned student is in
proper physical condition to participate in the dance program. I do, hereby, authorize Cynthia Hixson or the staff of
Dianna Durkin Dance Studio to obtain medical treatment for my child in emergency situations where I cannot be reached. I
understand that I am responsible for the payment of any medical expenses and in no circumstances is Cynthia Hixson
or Dianna Durkin Dance Studio responsible for payment of medical expenses. This authority includes the authority to
authorize any and all emergency treatment deemed necessary by a licensed physician.
Photo/Video Release
-I grant permission for any photo/images/video of the student above, to be published as advertisement, on Dianna Durkin Dance Studio behalf, in a safe and tasteful manner, carefully selected by the staff of Dianna Durkin Dance Studio. I understand that no compensation will be allotted for the use of these photographs or videos.
Policy Agreement
-I have read completely, understood fully, and agree to all of the Dianna Durkin Dance Studio's financial and other policies.
-I understand this waiver does not expire.
