Loading...

PARTICIPANT AGREEMENT, RELEASE & ASSUMPTION OF RISK & Class/school rules. 

 

In consideration of the services of Pittsburgh Circus Center, their agents, owners, officers, volunteers, employees, contractors, instructors, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as “PCC”), I hereby agree to release, indemnify, and discharge PCC, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows:

 


I acknowledge that my participation in Circus Arts and/or any other program/class that PCC offers, entails known and unanticipated risks that could result in physical or emotional injury, paralysis, death, dismemberment, and/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 may include but are not limited to: slips, trips and falls; falling from equipment; collision with other participants, spectators,or objects; rope burns; silk burns; tape irritation; allergic reactions; pinches, scrapes, bruises, contusions, lacerations, open cuts/blisters, skin irritation, twists, strains, sprains, jolts, fractures,concussions, minor and major joint/tendon/bone/cranial/spinal- cord /nerves/muscle/skin/mucosa/ eye/ear/nose/oral/genital injuries,miscarriage, exposure/infection of illness/disease/fungal/bacterial/viral and other severe life threatening hazards and dismemberment; the negligence of other participants, faulty equipment of any and all kind, building structure/stairs/plumbing/ electricity/heat/gas/flooring/ceiling/walls/paint etc.,visitors, or any other person who may be past or present; psychological injuries or physical damage associated with this activity. In any event, if you, your child, your spouse or any other person/animal /thing accompanying you is injured/broken/damaged/stolen, any and all medical/psychological assistance, replacement value will be at your own expense. 

 Furthermore, PCC’s  instructors/volunteers are fully trained to verbally and physically teach Circus Arts. Instructors seek safety, but they are not infallible. They might be unaware of a participant’s fitness or abilities if the participant hasn’t made it well know. They may not be able to see a known injury of participant. They may not be able to notice a pregnancy.  They may not be aware of special needs or fully understand the limitations of particular special needs. It is the responsibility of you, the participant, participants parent/legal guardian, POA, representative or agent, to full disclose any additional information that is pertinent to partaking in Circus Arts class. 

The inherent risk of partaking in activities at PCC includes possible injuries outside the building i.e slips and falls on the stairs. While we impeccably maintain the property to ensure the stairs are clear of debris, snow etc, accidents, that are no fault of PCC can happen that do not directly involve an apparatus inside our center. . 

I expressly agree and promise to accept and assume allof the risks existing in the activities offered by PCC.

 My participations in PCC activities is purely voluntarily, and I elect to participate in spite of the risks mentioned and unmentioned in this waiver. I hereby voluntarily release,forever discharge, and agree to indemnify and hold harmless PCC from any and all claims,demands, or causes of action, which are in any way connected with my participation in the activities or my use of PCC’s equipment or facilities, including any such claims which allege negligent acts or omissions of PCC

 Should PCC or anyone acting on their behalf, be required to incur attorney’s fee and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. I agree to pay upfront or repay any legal costs that PCC or its agents would incur relating to my presence at their activity. 

I certify that I have adequate insurance to cover any injury or damage I may cause to suffer while participating, or else agree to bear the costs of such injury or damage. I further certify that I am willing to assume the risks of any medical or physical condition I may have.

I am agreeing to waiver all rights of bringing lawsuit/magistrate/police/bill collectors/private investigator/GPStracking/eaves dropping/defaming/ slandering/cyber bullying/cyber squatting/legal mailings/legal paperwork of any kind to and or against PCC and ANY of the their agents,instructors,friends, family members,customers,spectators,visitors, building owners, vendors, contractors,maids,or any other persons affiliated in any capacity to PCC in any state or country, or counter action will be necessary by PCC.

I maybe, injured or disabled at this time and I fully understand the repercussions and risks of participating in PCC’s activities. I understand that if I am pregnant or become pregnant, I will not participate in any circus arts class that involves being airborne (both feet off the ground) or a grounds class that falls within circus arts. I agree to ask for an appropriate class, if any is available, that I may participate in while being pregnant. I understand that PCC firmly forbids anyone pregnant in a circus arts class. I am testifying that I am currently not pregnant or am pregnant and know/understand the rules of participation if I become pregnant.  PCC has the right to insist that I not partake in activities due to inherent risks of pregnancy. 

 By signing this document, I acknowledge that if anyone is hurt or property is damaged/stolen during participation in PCC’s activities, I will be found by a court of law to have waived my right to bringa lawsuit or any legal action against PCC on the basis of any claim from which I have released them herein. 

I also agree that this document is valid for this and any subsequent visits and participation with PCC both indoors and out.  

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. 

This waiver is valid for an indefinite amount of time or until PCC asks that I sign a new waiver. 

 General PCC rules:

COVID Due to Covid regulations, the following must be implemented: All persons must refrain from PCC activities and appearance in the building if there has been know infection or exposure to Covid or any symptoms set forth by the CDC that may indicate Covid. 

Sanitation: PCC may request sanitizer be placed on hands and soles of feet before entering the main circus floor. You may opt for washing at the sink. 

Proper attire:

PCC has a very strict attire/uniform policy. I am agreeing to adhere to the following attire rules:

Students must wear form fitting cotton type athletic clothing (leggings/Capri/) which fully cover armpits with hair, midriff, lower back and back of the knees. Baggy clothing is not permitted and will be asked to be removed. No jewlery/watch/accessory of any kind is allowed including jewlery that can not be seen. Implanted jewlery, such as transdermal gems, must be brought to the instructors attention and may preclude my participation in some or all classes. Longer hair MUST be kept in ponytail/braid/bun or equivalent without the use of plastic hair clips. Scented lotions, perfumes, oils are not allowed. Fingernails must be short enough that a fist can be made. The use of tips, press on or any other nail extension may preclude my participation in some or all classes. Pointed shaped nails of any length is prohibited. I agree to follow the rules for shoes/socks or bare feet. I also agree to chose clothing that does not have vulgar language or hate speech printed on it. 

I understand and agree to the use of candy, gum, removable retainers, or any food products, are not allowed while participating in a class.  

I understand and agree to a non smoking/vaping policy inside PCC. 

As with any recreation facility that is open to the public, all steps are necessary to ensure the facility remains clean, safe, welcoming, politically neutral, non competitive and family friendly for all ages.  

By signing this waiver, I am also agreeing that I have taken the time to read the entire document and ask questions if I am confused or concerned about anything stated in this document.  


First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*

Phone*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*

Phone*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*

Phone*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*

Phone*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*

Phone*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*

Phone*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*

Phone*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*

Phone*
Tenth Participant's Date of Birth*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. Paper copies are not available however an electronic signed copy will be sent to your email address provided.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!