I release KleinDance Arts LLC, owners, teachers, staff, and renters of KleinDance Arts from any liability or sickness associated with any activity that I and/or student/s will be involved in while attending class (in-person/virtual) and/or using/renting studio space.

I hereby grant KleinDance Arts LLC, owners, teachers, staff and renters permission to publicly use images and/or video taken that I and/or student/s will be in while attending class and/or using/renting studio space.

Participant (18 years or older) OR Parent/Guardian Signature (If under 18 years of age)

I release KleinDance Arts LLC, owners, teachers, staff, and renters of KleinDance Arts from any liability or sickness associated with any activity that I and/or student/s will be involved in while attending class (in-person/virtual) and/or using/renting studio space.

I hereby grant KleinDance Arts LLC, owners, teachers, staff and renters permission to publicly use images and/or video taken that I and/or student/s will be in while attending class and/or using/renting studio space.

Participant (18 years or older) OR Parent/Guardian Signature (If under 18 years of age)

I release KleinDance Arts LLC, owners, teachers, staff, and renters of KleinDance Arts from any liability or sickness associated with any activity that I and/or student/s will be involved in while attending class (in-person/virtual) and/or using/renting studio space.

I hereby grant KleinDance Arts LLC, owners, teachers, staff and renters permission to publicly use images and/or video taken that I and/or student/s will be in while attending class and/or using/renting studio space.

Participant (18 years or older) OR Parent/Guardian Signature (If under 18 years of age)

If a client of KDA requires medical assistance, KDA staff will call the nearest hospital, the client's contact #1, contact #2, as well as the client's emergency contact.

Participant (18 years or older) OR Parent/Guardian Signature (If under 18 years of age)

I have read, understand and agree to KDA's Payment Policy. A $15 late fee will be added to your account if tuition is not paid after the 1st of the month.

Please visit our website (www.kleindancearts.com) and read our Studio Policies. If you have any questions, please email kleindancearts@gmail.com OR call/text 805-268-2530. Please check your portal account every month to make sure you are enrolled in the correct classes and tuition is paid for. You can save your spot in class by adding classes to your portal account up to 3 months in advance. Make sure your portal account is set to auto-pay/self-pay to avoid late fees. Please email kleindancearts@gmail.com with any questions.

Participant (18 years or older) OR Parent/Guardian Signature (If under 18 years of age)

I understand that monthly private lessons include 4 lessons. *Additional private lessons can be scheduled and added to your portal account.*

Participant (18 years or older) OR Parent/Guardian Signature (If under 18 years of age)

Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea

Look for emergency warning signs for COVID-19. If someone is showing any of these signs, seek emergency medical care immediately:
- Trouble breathing
- Persistent pain or pressure in the chest
- New confusion
- Inability to wake or stay awake
- Bluish lips or face

I agree to the following:

- I understand the aforementioned COVID-19 symptoms.

- I affirm that neither I, nor any member of my household, currently has or has experienced the aforementioned symptoms within the past 14 days. Furthermore, I will immediately inform KleinDance Arts LLC, owners, teachers, staff, and/or renters and discontinue classes if I, or any member of my household, develops any of the aforementioned symptoms.

- I affirm that neither I, nor any member of my household, has been diagnosed with COVID-19 within the past 30 days. Furthermore, I will immediately inform KleinDance Arts LLC, owners, teachers, staff, and/or renters and discontinue classes if I, or any member of my household, is diagnosed with COVID-19.

- I affirm that neither I, nor any member of my household, has knowingly been exposed to anyone diagnosed with COVID-19 within the past 30 days. Furthermore, I will immediately inform KleinDance Arts LLC, owners, teachers, staff, and/or renters and discontinue classes if I, or any member of my household, is knowingly exposed to anyone diagnosed with COVID-19.

- I affirm that neither I, nor any member of my household, has traveled outside of the country or to any city considered to be a "hot spot" for COVID-19 infections within the past 30 days. Furthermore, I will immediately inform KleinDance Arts LLC, owners, teachers, staff, and/or renters and discontinue classes once I, or any member of my household, returns from traveling outside of the country or to any city considered to be a "hot spot" for COVID-19 infections.

- I understand that KleinDance Arts LLC, owners, teachers, staff, and/or renters cannot be held liable for any exposure to the COVID-19 virus caused by any misinformation on this form or the health history provided by each Student.

Any legal disputes with the KleinDance Arts LLC, owners, teachers, staff, and renters will be subject to Santa Barbara Jurisdiction.

KleinDance Arts LLC, owners, teachers, staff, and renters will be adhering to the following enhanced procedures to prevent the spread of COVID-19.

Our instructors and staff will...

- Do a temperature check before entering the studio, and ensure that it is below 100.4°F.
- Clean/Disinfect frequently touched surfaces thoroughly and at regular intervals.
- Wash/Sanitize our hands before and after each session.
- Wear our masks when in close contact.
- Maintain a safe distance at all times.
- Accommodate a limited number of students in each class to ensure physical distancing.
- Schedule classes so as to allow time for cleaning/disinfecting surfaces and allow students to finish and leave the studio before the next set of students arrive.
- Provide sanitizers in the reception area and other locations within the premises.

We are requesting that each of our students, please...

- Allow us to check their temperature before entering the premises to ensure it is below 100.4°F.
- Wear a face mask within the building and within the studio.
- Maintain a safe distance from others at all times.
- Use the hand sanitizer before entering and while exiting the studio.
- Carry their own resuable water bottle.

By checking the box, I agree to each statement above and release KleinDance Arts LLC, owners, teachers, staff and renters from any and all liability for the unintentional exposure or harm due to COVID-19.

KleinDance Arts LLC, owners, teachers, staff and renters agree to abide by these standards and affirms the same.

Participant (18 years or older) OR Parent/Guardian Signature (If under 18 years of age)