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COVID-19 Waiver of Liability, Release, and Indemnity Agreement for DanceFIT Studio


The Commonwealth of Massachusetts remains under a declaration of state of emergency due to the 2019 novel coronavirus, COVID-19, a contagious respiratory virus that is mainly spread from person-to-person contact.  DanceFIT Studio, LLC (“DanceFIT”), has been allowed to open for in-person instruction, provided it follows orders and guidance from the Massachusetts Department of Public Health and other state and local officials regarding protocols to reduce the risk of exposure to COVID-19.  DanceFIT, however, cannot guarantee that its Clients, including you and/or your child(ren), will not be exposed to or infected with COVID-19 as a result of in-person attendance at classes and events, held in-studio or off-site (the “Program”).

By signing this COVID-19 Waiver of Liability, Release, and Indemnity Agreement:

1.    I acknowledge that the in-person Program schedule (up to and including immediate cancellation), permitted activities, and Program/Client capacity may change at any time with or without notice, in accordance with state or local orders or guidance.

2.    I acknowledge that DanceFIT may impose standards and conditions with respect to personal protective equipment, social distancing, and other public health measures that Clients must follow, and that failure to do so may result in my and/or my child(ren)'s immediate exclusion from the Program and the Program premises.

3.    I acknowledge the contagious nature of COVID-19 and I voluntarily assume the full risk on behalf of myself and/or my child(ren) (including but not limited to my/our heirs, personal representatives, next of kin, estates, and administrators) that we may be exposed to or infected with COVID-19 by attendance at the Program, and that such exposure or infection may result in personal injury, illness, disability, death, damage, loss, claim, and/or expense, whether now or in the future.  I accept sole responsibility for any such outcome that the I and/or my child(ren) may experience or incur in connection with attendance at the Program.  I understand that such exposure may result from the actions, omissions, or negligence of myself and others, including, but not limited to DanceFIT instructors, staff, volunteers, agents (including off-site Program premises owners), representatives, and other Clients.

4.    I agree to indemnify, save, release, covenant not to sue, discharge, and hold harmless DanceFIT and its instructors, staff, volunteers, agents (including off-site Program premises owners), representatives, and Clients, from any and all liability, claims, demands, actions, suits, loss, and causes of action that I and/or my child(ren) may incur, including court costs and attorneys’ fees, arising out of or related to any loss, damage, or injury, including, but not limited to, death, illness, injury and/or disease that in any way may be related to or arising out of COVID-19 that may be sustained by myself and/or my child(ren) in connection with attendance at the Program, regardless of whether such claims arise in tort, contract, strict liability, or other legal theory.

5.    I agree that this document shall be construed in accordance with the laws of the Commonwealth of Massachusetts.  In the event any portion of this document is deemed unlawful or unenforceable, said portion shall be severable and the remaining terms shall continue in full force and legal effect.

6.    I understand that by signing this document, I am binding myself and/or my child(ren) to its terms.  I certify that I am 18 years of age or older, legally competent and authorized to sign this document on behalf of myself and/or my child(ren), and I have accepted it of my own free will.

 

I have read this COVID-19 Waiver of Liability, Release, and Indemnity Agreement and fully understand its terms.  I understand that by signing this document I have given up substantial rights on behalf of myself and/or my child(ren).  I have signed this document freely and voluntarily, and I intend that my signature be a complete and unconditional release of all liability to the greatest extent allowed by law.

 

 

 

First Participant's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

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