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CONSENT, RELEASE, AND WAIVER AGREEMENT

On behalf of myself or the child named below (the “Student”), I, the undersigned, hereby authorize Lonestar Dance Center LLC, a Texas limited liability company hereinafter referred to as Lonestar Dance Center, its agents, representatives, owners, contractors, and employees (collectively, the “Company”) to administer simple first aid to the Student in the event of minor injuries, and understand that family members or doctors will be called when in the discretion of the Company it is deemed necessary. If I cannot make arrangements for emergency medical attention at the time of serious illness or injury of the Student, I hereby authorize the Company to take any action as necessary for the Student’s well-being, including, but not limited to, transporting the Student to a nearby hospital, in the discretion of the Company. I further agree to be financially responsible for any medical services provided to the Student. I am aware that dancing, and the exercises associated with it, place unusual stresses on the body, and carry with them the risk of physical injury. On behalf of myself or my child (the Student), I hereby assume all risks and agree that the Company shall not be liable in any way for any injuries sustained during attendance at Lonestar Dance Center or any of its related functions. I AGREE THAT THE COMPANY SHALL NOT BE LIABLE FOR ANY DAMAGES, CLAIMS, OR COMPENSATION OF WHATEVER NATURE (INCLUDING LIABILITY FOR NEGLIGENCE, STRICT LIABILITY, OR OTHERWISE) THAT MAY ARISE IN THE NAME OF OR FOR THE BENEFIT OF THE STUDENT AND/OR ANY OTHER PERSON AS A RESULT OF PERSONAL INJURY WHILE ON THE PREMISES OF THE COMPANY OR OTHERWISE IN THE CARE OF THE COMPANY, INCLUDING ANY SUCH INJURIES SUSTAINED WHILE THE STUDENT IS BEING TRANSPORTED BY THE COMPANY. I HEREBY AGREE TO RELEASE, WAIVE, COVENANT NOT TO SUE, INDEMNIFY, AND HOLD HARMLESS THE COMPANY FROM ANY AND ALL LIABILITY, CLAIMS, DEMANDS, JUDGMENTS, ACTIONS, EXECUTIONS, AND CAUSES OF ACTION WHATSOEVER. I UNDERSTAND THAT I AM WAIVING MY RIGHT TO TAKE LEGAL ACTION, INCLUDING FILING A LAWSUIT FOR INJURIES TO MYSELF AND/OR MY CHILD (THE STUDENT).

On behalf of myself or my child the Student, I further hereby grant the Company the absolute right and permission to take and use photographs and/or videos of the Student during attendance at the Lonestar Dance Center or any of its related functions. I understand that the photograph(s) and/or video(s) may be used in a publication, print ad, direct mailing, electronic media (e.g., the internet, presentations, etc.), and/or other form of promotion. I release the Company, the photographer, their offices, employees, agents, and designees from liability for any violation of any personal or proprietary right I and/or the Student may have in connection with such use(s). Neither I nor the Student will make any monetary or other claim against the Company for the use of any such photograph(s) and/or video(s). I acknowledge and agree that the execution and delivery of this instrument to the Company is a condition precedent and a material inducement to the Company to permit the Student to use the Lonestar Dance Center and/ or participate in any of the Company’s related functions, without which the Company would not have agreed to permit such use and/or participation. By signing below, I hereby represent and warrant that I am the parent or legal guardian of the Student and that I have complete capacity and authority to sign this instrument and approve the agreements set forth herein on behalf of myself and the Student.

-Lonestar Dance Center has put in place preventative measures to reduce the spread of COVID-19; however, Lonestar Dance Center cannot guarantee that you or your child(ren) will not become infected with COVID-19. Please agree to the following preventative measures to help reduce the spread of COVID-19.

-Participants should self-screen for any of the following new or worsening signs of symptoms of possible sickness before attending any scheduled lesson or class. If the participant demonstrates any of these symptoms they should remain at home and notify Lonestar Staff of their cancellation. -Cough, Shortness of breath or difficulty breathing, Chills, Repeated shaking with chills, Muscle pain, Headache, Sore throat, Loss of taste or smell, Diarrhea, Feeling feverish or a measured temperature greater than or equal to 100.0 degrees Fahrenheit, Known close contact with a person who is lab confirmed to have COVID-19 

I Agree

-Under these special circumstances employees are permitted to measure the body temperature of employees and participants who physically enter the workplace. Employers who choose to conduct temperature checks before allowing individuals to enter will not maintain any historical log.  

I Agree

-I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at Lonestar Dance Center or participation in Studio programming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless Lonestar Dance Center, its employees, contractors, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Lonestar Dance Center, its employees, contractors, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Lonestar Dance Center program. 

I Agree


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First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Parent or Guardian's Email Address
Email*
Check to receive information, news, and discounts from Lonestar Dance Center by e-mail.
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
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*
Relationship*
Phone*
Parent or Guardian's Date of Birth*
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. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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