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Love/Aerial 
1260 Triangle Ct. 
West Sacramento, CA 95605
916-572-5288
loveaerialsacramento@gmail.com

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT (“AGREEMENT”)

In consideration of participating in the activities with Love/Aerial and any instructors associated with Love/Aerial, I represent that I understand the nature of this activity and that I am qualified, in good health, and in proper physical condition to participate in such activity. I acknowledge that if I believe conditions are unsafe, I will immediately discontinue participation in the activity. I acknowledge that I am voluntarily participating in this activity. I am fully aware that aerial arts (i.e. aerial silks, aerial hammock, trapeze, lyra/aerial hoop, dance, rope, corde lisse, straps, acrobatics, and related activities) contain dangers and inherent risks (including serious injury or death), that no amount of care, caution, instruction, or expertise can eliminate. I understand the scope, nature and extent of the risks involved and voluntarily and freely choose to assume any and all such risks. I fully understand that this activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the “releasees” named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, cost, and damages I incur as a result of my participation in the activity.

I hereby release and discharge Love/Aerial or any instructors associated with Love/Aerial, its respective administrators, owners, directors, agents, officers, volunteers, employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the activity takes place, (each considered one of the “RELEASEES” herein) from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the “Releasees” or otherwise, including negligent rescue operations and future agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the Releasees from any loss, liability, damage, or cost, which any may incur as a result of such claim. Parents and/or guardians are solely responsible for transporting their minor to and from the facility safely and holds Love/Aerial and any instructors associated with Love/Aerial harmless of any events that may occur leaving or coming in to the facility.

I hereby grant Love/Aerial and any instructors associated with Love/Aerial, permission to interview me and/or to use by likeness in photograph(s)/video in any and all of its publications and in any and all other media, whether now known or hereafter existing, controlled by Love/Aerial, in perpetuity, and for other use by Love/Aerial. I will make no monetary or other claim against Love/Aerial or any instructors associated with Love/Aerial, for the use of the interview and/or photograph(s)/video.

Love/Aerial or any instructors associated with Love/Aerial may terminate this Agreement or any specific services paid for in advance without cause on 7 days’ notice to the other party. Outstanding fees due to advance payment will be refunded to the party on the appropriate prorated rate. 

I have read the RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect. I acknowledge that I have been advised to obtain independent legal advice concerning the ramifications of signing this document.

July 7, 2020

First Participants Name

First Name*

Middle Name

Last Name*

Phone*
First Participants Date of Birth*
First Participants Signature*
Second Participants Name

First Name*

Middle Name

Last Name*
Second Participants Date of Birth*
Third Participants Name

First Name*

Middle Name

Last Name*
Third Participants Date of Birth*
Fourth Participants Name

First Name*

Middle Name

Last Name*
Fourth Participants Date of Birth*
Fifth Participants Name

First Name*

Middle Name

Last Name*
Fifth Participants Date of Birth*
Sixth Participants Name

First Name*

Middle Name

Last Name*
Sixth Participants Date of Birth*
Seventh Participants Name

First Name*

Middle Name

Last Name*
Seventh Participants Date of Birth*
Eighth Participants Name

First Name*

Middle Name

Last Name*
Eighth Participants Date of Birth*
Ninth Participants Name

First Name*

Middle Name

Last Name*
Ninth Participants Date of Birth*
Tenth Participants Name

First Name*

Middle Name

Last Name*
Tenth Participants Date of Birth*
Parent or Guardian's Email Address

Email*
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A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's 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.
Parent or Guardian's Name

First Name*

Middle 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. 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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