Loading...

BREUIL FUSSION ACADEMY,CORP 

COVID-19 WAIVER OF LIABILITY AND INDEMNITY AGREEMENT 2020

13501 NW 107 AVE,HIALEAH GARDENS,FL,33018.

 

 

 

 

 

 

 

BREUIL FUSSION ACADEMY,CORP 

COVID-19 WAIVER OF LIABILITY AND INDEMNITY AGREEMENT 2020

13501 NW 107 AVE,HIALEAH GARDENS,FL,33018.
 

Returning to BFA Dance Studio 

Here’s what to know before you come visit us.

As we prepare for a phased reopening, we’ve made updates based on guidance from health authorities, such as the Centers for Disease Control and Prevention (CDC) and appropriate government agencies. These measures are designed to promote:

Cleanliness
Physical distancing
Reduced contact

It may be different from the last time you visited. But together, we can find new ways to create magical moments—and memories to treasure.

By reading, initialing, and signing this form in its entirety, I fully consent that my child/dancer and myself are both entirely aware of the new guidelines and studio protocols that have become effective at BREUIL FUSSION ACADEMY. By completing this form, I have agreed to all new policies and will adhere to their regulations through the duration of the time that they are in place and required for all participants and dancers at Breuil Fussion Academy.

I acknowledge that participation is fully voluntary, and I willingly choose to allow my dancer/child to participate. I agree the hold Breuil Fussion Academy  harmless of any liability.

(PLEASE READ CAREFULLY AND AGREE)

  • Dancers Drop off and Pick up.

    I Agree
    Only the student will be allowed to enter the classroom. All parents or guardians must wait on the ground floor and not in the lobby as usual to avoid crowds in a public area and maintain social distance.If your dancer exhibits any symptoms while at BFA DANCE, the parent or guardian will be immediately notified and asked to promptly pick up their dancer.

  • Temperature screenings

    I Agree
    The temperature check will be mandatory before entering the dance hall. Any dancer registering a temperature of 99.7 degrees or higher, will not be permitted to get in the facility  and will be asked to return home.

  • Face coverings  

    I Agree
    For all staff and students (ages 2 and up) the use of masks will be mandatory.

  • Stay at home

    I Agree
    All students with fever or without a mask will not be allowed to enter the class.All students who present symptoms or feel unwell we ask that they please do not attend class. Their absence will be justified.

  • Wash your hands.

    I Agree
    All students will be required before and after each class to wash their hands or apply hand sanitizer.

  • Social Distancing

    I Agree
    The students in the classes will be separated from each other by 6ft distance where they will carry out class movements respecting social distancing. The space in class groups will be limited to 10 students.

  • Dance Shoes in your bag.

    I Agree
    In order to stay healthy and safe it will be mandatory that all dancers bring DANCE SHOES, accessories and (WATER BOTTLE) IN THEIR TRAINING BAG. Everything must be clearly labeled with the student's name. The use of the water fountain will not be allowed.

  • Contactless payments 

    I Agree
    In order to avoid physical contact, we will not accept payments by check or cash at the moment. Each parent or guardian of the student will receive a monthly invoice that will allow you to make the payment with a debit or credit card. BFA will also offer you the option to send your payments through the established digital platforms Zelle, QuickPay or Cash App, remember to add the full name of the student.All agreement forms and the registration process will be done online and are available on our website.

I Agree
Breuil Fussion Academy  will not be held responsible for any symptoms shown or illness developed after the start of BFA Dance Studio Fussion Dance Program on Monday, July 6, 2020.

I Agree
 All parents that wish to register/return their dancer and choose to have them participate in the 2020 Fussion Dance Program , do so at their own risk and the risk of their dancer/child.

I HAVE READ THIS RELEASE AND WAIVER OF LIABILTY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT, FULLY UNDESTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE, OR GUARANTEE BEING MADE TO ME AND INTEND MY SIGNATURE TO BE COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILTY TO THE GREATEST EXTENT ALLOWED BY LAW.

(PLEASE BE SURE TO READ CAREFULLY ABOVE BEFORE SIGNING)

March 29, 2024

 

First Dance Participant's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

Last Name*
Second Dance Participant's Date of Birth*
Third Dance Participant's Name

First Name*

Middle Name

Last Name*
Third Dance Participant's Date of Birth*
Fourth Dance Participant's Name

First Name*

Middle Name

Last Name*
Fourth Dance Participant's Date of Birth*
Fifth Dance Participant's Name

First Name*

Middle Name

Last Name*
Fifth Dance Participant's Date of Birth*
Sixth Dance Participant's Name

First Name*

Middle Name

Last Name*
Sixth Dance Participant's Date of Birth*
Seventh Dance Participant's Name

First Name*

Middle Name

Last Name*
Seventh Dance Participant's Date of Birth*
Eighth Dance Participant's Name

First Name*

Middle Name

Last Name*
Eighth Dance Participant's Date of Birth*
Ninth Dance Participant's Name

First Name*

Middle Name

Last Name*
Ninth Dance Participant's Date of Birth*
Tenth Dance Participant's Name

First Name*

Middle Name

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

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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*

Middle Name

Last Name*

Relationship*

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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!