Release from Liability and Participant Disclosure

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*

First Participant's Date of Birth*

First Participant's Signature*

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Participant's Address

Address Line 1:*

Street address, P.O. box, company name, c/o

Address Line 2:

Apartment, suite, unit, building, floor, etc.

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City:*

State/Province:*

Zip/Postal:*

Parent or Guardian's Email Address

Email*

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Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*

Insurance

Insurance Carrier*

Insurance Policy Number*

Release from Liability and Indemnity Agreement

Participant Agreement, Release from Liability and Assumption of Risk. In consideration of the services of Spokane Aerial Performance Arts LLC, their agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as "SAPA"), I hereby agree to release, indemnify, and discharge SAPA, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representatives and estate as follows: I acknowledge that my participation in circus arts 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; pinches, scrapes, twists and jolts that could result in scratches, bruises, sprains, lacerations, fractures, concussions, or even more severe life threatening hazards; strains, cuts, bruises, 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. Traveling to and from shows, meets and exhibitions raises the possibility of any manner of transportation accidents. In any event, if you or your child is injured, you or your child may require medical assistance, at your own expense. Furthermore, SAPA employees have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of a participant's fitness or abilities. They might misjudge the weather or environmental conditions. They may give incomplete warnings or instructions, and the equipment being used might malfunction. 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. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless SAPA 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 SAPA's equipment or facilities, including any such claims which allege negligent acts or omissions of SAPA. Should SAPA 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. 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. In the event that I file a lawsuit against SAPA, I agree to do so solely in the state of Washington, 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. I understand that this Release Agreement is a legally binding contract and shall remain in effect for the duration of my or my children's participation in Spokane Aerial Performance Art's activities. This Release agreement shall bind my heirs, personal representatives, assigns and all members of my family, including minors. 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 SAPA 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. *

YES, I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS RELEASE FROM LIABILITY AND INDEMNITY AGREEMENT BY READING THIS BEFORE SIGNING IT.

NO, I DO NOT AGREE

Payment Policies

All payments are due prior to the first day of the session. Payments for classes are processed automatically each day. Be aware that any registrations not paid at the time of registration will be canceled and you will lose your space in class. I represent and warrant that if I am purchasing something from this facility or from Merchants that (i) any credit or bank account draft (ACH Draft) information I supply is true and complete, (ii) charges incurred by me will be honored by my credit card company or financial institution, and (iii) I will pay the charges incurred by me at the posted prices, including any applicable taxes, fees, and penalties. I hereby authorize (if online payment is made or autopay information is provided) this facility to charge my bank, or credit card account. I understand that a 30 day written notice is required to terminate billing and I am responsible for payment whether or not my student attends classes until I notify this facility in writing to drop my student from classes. Should I dispute a charge through my financial institution this will constitute a breach of contract possibly resulting in, but not limited to, penalties, additional fees, collection, legal action, and/or termination of any and/or all current and future service. *

YES, I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THE PAYMENT POLICIES BY READING THIS BEFORE SIGNING IT.

NO, I DO NOT AGREE.

Rules, Terms and Conditions

I accept that Spokane Aerial Performance Arts offers NO REFUNDS, except in the event of class closure initiated by Spokane Aerial Performance Arts. Spokane Aerial Performance Arts offers no refunds in the case of a local or national disaster. The gym floor and equipment are to be used DURING CLASS TIME ONLY UNDER THE SUPERVISION OF A SPOKANE AERIAL PERFORMANCE ARTS INSTRUCTOR ONLY. Absolutely NO-ONE is allowed on the main gym floors, trampolines, or other equipment at any time outside of or between classes, regardless of age, level of physical fitness or experience, or student tenure at Spokane Aerial Performance Arts. Listening, paying attention, following instructor directions and safety rules will help you and/or your child get the most out of your Spokane Aerial Performance Arts class. Disruptive behavior can be dangerous and is not tolerated. If a student continues to exhibit disruptive behavior after repeated warnings and timeouts, instructor may ask the child to sit out the remainder of a class. It is helpful if parents can help reinforce the importance of paying attention and following directions in class. ADULT students are likewise expected to follow all instructor directives and may also be asked to leave class if any behavior or activities are deemed unsafe or disruptive by the instructor. Consumption of drugs or alcohol prior to participation in class is highly unsafe and students under the influence of either will be immediately ejected from class, with no refund or make-up given for the missed class. *

I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THE RULES, TERMS AND CONDITIONS BY READING THIS BEFORE SIGNING IT.

NO, I DO NOT AGREE.

Safety

Students may not chew gum or have food on the gym floor Students and guests are not allowed on the gym floor before or after class and must always stay off of the equipment unless supervised by a instructor. Be on time for class! Missing the warm up may be a hazard. Students who are less than 10 minutes late will be instructed to complete the necessary warm up before participation can take place and may have to miss out on certain activities if a warm up in the gym is not done. Disruptive behavior will not be tolerated. Spokane Aerial Performance Arts reserves the right to cancel a student's enrollment at any time. Parents are allowed in designated waiting area only. ONLY students and instructor are allowed on the gym floor. Please park in designated spaces only. No horseplay at any time in the facility or on the grounds. *

I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THE SAFETY RULES BY READING THIS BEFORE SIGNING IT.

NO, I DO NOT AGREE.

Arrival, Observation and Departure

Warm up time is essential for your safety; please plan to arrive on time. Students (adult & children) arriving more than 10 min late for class may not be admitted to class. Shoes, coats, and extra clothing should be kept on the benches or in the lockers (lockers do NOT lock). Do not bring valuables to class. All students should remain on the north side of the stanchions, near the orange benches until their class is called out to the gym. Parents please pick students up promptly after their class is completed. Students (children and/or minors) are not allowed to leave the building except with a parent or other responsible adult. Parents you MUST come inside to pick up your child. Parents and visitors are welcome and encouraged to observe classes. It is important, however, parents and visitors remain in the viewing area and not proceed into the gym area. PLEASE do not allow your children to run around, "jump or climb", or do gymnastics in the viewing areas. The benches are provided for safe and quiet viewing. Siblings, friends, and other children must have adult supervision at all times. Please make every effort to keep the viewing area clean and neat. *

I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THE ARRIVAL, OBSERVATION AND DEPARTURE SECTION BY READING THIS BEFORE SIGNING IT.

NO, I DO NOT AGREE.

Makeup Classes

NO MAKEUP CLASSES ARE AVAILABLE FOR ANY REASON. Spokane Aerial does not offer credits, transfers or refunds. Spokane Aerial does not refund for illness or injury. Missed classes will not result in prorated tuition or refund, and do not carry over between Sessions. Occasional missed classes are acceptable but cannot be made up or prorated. *

I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE POLICIES FOR MAKEUP CLASSES BY READING THIS BEFORE SIGNING IT.

NO, I DO NOT AGREE.

Jewelry and Attire Policies

Student must dress appropriately. For males, T-shirt & athletic shorts. For females, leotards and/or leggings with t-shirt. Most fitness/athletic clothing without strings, buttons, zippers or other restrictive are also acceptable. NO JEANS! Cyr Wheel students must bring "indoor" shoes for class. Fire students will be required to wear cotton, non-flammable clothing. Bare feet are recommended. Footed tights are not allowed. Jewelry is NOT allowed. Rings, toe rings, earrings, nose rings, belly rings, and any other piercing is not allowed and must be removed prior to the start of class. Rings and necklaces must be removed prior to the start of class. Do NOT bring valuables to class. Spokane Aerial Performance Arts is not responsible for the loss of personal items. Students must have hair tied back away from his/her face. Students must wear a headband to secure their glasses, if applicable. *

I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE JEWELRY AND ATTIRE POLICIES BY READING THIS BEFORE SIGNING IT.

NO, I DO NOT AGREE.

Personal Hygiene

Students cannot have long fingernails or toenails for silk or lyra classes. All nails should be even with the end of the finger or toe without any sharp edges. Long fingernails or toenails will have to be cut and filed smooth before students will be allowed to participate in class. This includes children's classes. Please come to class with clean garments and no perfume or scented lotions. The aerial silk apparatus' are used by others and smells tend to "stick" to the silk. Shirts with sleeves are best for hygiene and also to prevent burns in the arm pit area when sliding down the silks. Please do not come to class when you are sick. Viruses and flus are easily spread in our setting. Feel free to email Spokane Aerial if you have questions about this. *

I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THE PERSONAL HYGIENE POLICY BY READING THIS BEFORE SIGNING IT.

NO, I DO NOT AGREE.

Equipment

Student may be responsible for the replacement of equipment (silks) if they are the cause of damage due to attire (see above). Rings, piercings, zippers and other mentioned items above can cause ruin the silks by causing holes and tears. *

I AGREE AND I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THE EQUIPMENT USE POLICY BY READING THIS BEFORE SIGNING IT.

NO, I DO NOT AGREE.

Medical Information

Does self/child have ANY medical or learning problems that will interfere with aerial and circus arts? *

YES

NO

I am the parent or legal guardian of the child(ren) identified in this waiver and I voluntarily authorize my child(ren) to participate in aerial activities at Spokane Aerial. *

Yes

No

N/A

Minimum Health Requirements

Basic I Level classes are designed for new students who may not have a lot of core or upper-body strength. All levels, ages, and body types are welcome. Students must be in good health to participate in such activity. Clients with the following physical limitations should consult their doctor before participating in aerial acrobatics: Pregnancy, glaucoma, recent surgery (esp. shoulder, eyes, back, hips, hands or wrist), heart disease, very high or low blood pressure, easy onset vertigo, osteoporosis / bone weakness, recent head injury, cerebral sclerosis, propensity for fainting, carpal tunnel syndrome, severe arthritis, sinusitis or head cold, hiatal hernia, disc herniation or acute, discogenic disease, recent stroke, artificial hips, radiculitis (inflammation of nerve root in spine), severe muscle spasms, botox injections (within 6 hours). *

I HAVE READ AND AGREE

NO, I DO NOT AGREE

Soreness and Stiffness

Aerial work is a highly intense fitness program. Expect to be sore after class. Soreness should last 2-3 days, and typically occurs in the fingers, forearms, back, and abs. If soreness lasts longer than 5 days, consider taking a break until completely healed. Even if new students are in good shape, as with any new movement practice, they will probably still experience soreness. Aerial work is a unique fitness program because it introduces the body to the instability of suspension. The body must strengthen all the tiny stabilizer muscles that don't normally get used. Expect to experience soreness regularly after class for about 4-6 weeks. Calluses are normal on the palms and fingers. *

I HAVE READ AND AGREE

I DO NOT AGREE

Physical Activity Readiness

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*

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