Then, read the following and submit your information at the end of the page.
In consideration of the services of Buffalo
Aerial Dance LLC, Metts Dance, Inc., Flips Gymnastics, and Dynamic
Training, their agents, owners, officers, volunteers, participants,
employees, and all other persons or entities acting in any capacity on their behalf,
I hereby agree to release, indemnify, and discharge Buffalo Aerial Dance
(hereinafter referred to as B.A.D.) and Metts Dance, Flips Gymnastics, and
Dynamic Training, on behalf of myself, my spouse, my children, my parents, my
heirs, personal representative and estate as follows:
1. I acknowledge that my participation in
trapeze, aerial arts, dance training, gymnastics training and instruction and
other various disciplines entails known and unanticipated risks that could
result in physical or emotional injury, paralysis, death, or damage to
myself, to property, or to third parties. I understand that such risks simply
cannot be eliminated without jeopardizing the essential qualities of the
activity.
The risks include, among
other things: slips and falls; falling from equipment;
rope burns, scrapes, twists and jolts that could result in
scratches, bruises, sprains, lacerations, fractures, concussions, or even
more severe life threatening hazards; strains, cuts, muscle soreness
and fractures; musculoskeletal injuries including head, neck, and back;
injuries to internal organs; the negligence of other people; my own physical
condition; and the risk of emotional and psychological injuries or physical
damage associated with this activity. In any event, if you or your child is injured, you or your child may require
medical assistance, at your own expense.
Furthermore, employees of B.A.D., Metts
Dance, Flips Gymnastics, and Dynamic Training have difficult jobs to perform.
They seek safety, but they are not infallible. They might have inaccurate or
incomplete information about a participant's fitness or abilities. They might
misjudge environmental conditions. They may give
incomplete warnings or instructions, and the equipment being used might
behave unpredictably.
2.
I represent that I am in good health and have had no known exposure to COVID-19 or any other infectious disease. I have had no symptoms of COVID-19, including cough, shortness of breath or difficulty breathing, chills, repeated shaking with chills, muscle pain, headache, sore throat, loss of taste or smell, diarrhea, or feeling feverish or a measured temperature greater than 99.6 degrees, for 14 days prior to attending the facility. I acknowledge that if I believe I have had any exposure to COVID-19, I will immediately cease attendance at the facility until I can again warrant that I have had no known exposure for the 14 day period and alert the facility if I have been on the premises since my exposure.
I am aware that training during and after the COVID-19 pandemic involves certain inherent risks, dangers and hazards, which can result in serious infection, personal injury or death. I further acknowledge, understand, appreciate, and agree that my participation may result in possible exposure to and illness from COVID-19. While protocols and personal discipline may reduce this risk, the risk of serious injury, illness, and even death is not possible to fully mitigate.
I hereby freely agree, to assume and accept all known and unknown risks of exposure to COVID-19, even arising from the negligence of the releasees or others and assume full responsibility for my participation. I further recognize and acknowledge that the risks inherent in training can be greatly reduced by, and therefore expressly agree to perform these safety precautions:
- Maintaining a minimum of 6 feet distance from other participants and staff
- Washing my hands thoroughly before and after my training session
- Doing my best to not touch my eyes, nose, mouth, or other parts of my face
- Wearing a mask securely over my nose and mouth as instructed by studio guidelines at the time
- Not coming to the studio if I experience any symptoms consistent with COVID-19, or have had a recent known or suspected exposure to a person with COVID-19
3. I expressly agree and promise to accept
and assume all of the risks existing in this activity. My participation in
this activity is purely voluntary, and I elect to participate in spite of the
risks.
4. I hereby voluntarily release, forever
discharge, and agree to indemnify and hold harmless B.A.D. and Metts Dance,
Flips Gymnastics, and Dynamic Training from any and all claims, demands, or
causes of action, which are in any way connected with my participation in
this activity or my use of B.A.D. and Metts Dance, Flips Gymnastics, and
Dynamic Training's equipment or facilities, including any such claims
which alleged or negligent acts or omissions of B.A.D. and Metts Dance, Flips
Gymnastics, and Dynamic Training.
5. Should B.A.D, Metts Dance, Flips
Gymnastics, or Dynamic Training or anyone acting on their behalf, be required
to incur attorney's fees and costs to enforce this agreement, I agree to
indemnify and hold them harmless for all such fees and costs.
6. I certify that I have adequate insurance
to cover any injury or damage I may cause or suffer while participating, or
else I agree to bear the costs of such injury or damage myself. I further
certify that I am willing to assume the risk of any medical or physical
condition I may have.
7. In the event that I file a lawsuit
against B.A.D, Metts Dance, Flips Gymnastics, or Dynamic Training, I agree to
do so solely in the state of New York, and I further agree that the
substantive law of that state shall apply in that action without regard to
the conflict of law rules of that state. I agree that if any portion of this
agreement is found to be void or unenforceable, the remaining document shall
remain in full force and effect.
By signing this document, I acknowledge
that if anyone is hurt or property is damaged during my participation in this
activity, I may be found by a court of law to have waived my right to
maintain a lawsuit against B.A.D., Metts Dance, Flips Gymnastics, or Dynamic
Training on the basis of any claim from which I have released them herein. I
have had sufficient opportunity to read this entire document. I have read and
understood it, and I agree to be bound by its terms.
PARENT'S
OR GUARDIAN'S ADDITIONAL INDEMNIFICATION
( for participants under the age of 18)
In
consideration of ("Minor") being permitted by B.A.D., Metts Dance,
Inc., Flips Gymnastics, and Dynamic Training to participate in its activities
and to use their equipment and facilities, I further agree to indemnify and hold
harmless B.A.D., Metts Dance, Inc.,
Flips Gymnastics, and Dynamic Training from any and all claims which are
brought by, or on behalf of Minor, and which are in any way connected with such
use or participation by Minor.