Loading...

Young Person Waiver and Release of Liability Form

IMPORTANT!!! Please read this carefully as this is a legal waiver and disclaimer.

Data Protection
The information you provide in this form will be used solely for dealing with you and/or your child(ren) as participants in any of the aerial classes. AcroAer Ltd has a Privacy Policy which can be requested at any time. Your data will be stored and used in accordance with this policy.

Please be aware that if you later decide to withdraw your consent and release of liability, you and/or your child(ren) can no longer participate in any of the aerial classes hosted by AcroAer Ltd and any data containing information related to you and/or your child(ren) will be destroyed.

Consent
In consideration of my being or my child being allowed to participate in any of the aerial classes, private lessons and/or to use the equipment, I agree to the following waiver and release.

I understand that aerial circus contains an inherent element of risk and can be a dangerous art form. In taking part in aerial classes I acknowledge this and understand that all possible steps will be done to reduce the risk to acceptable levels. Safety procedures and good practice must be observed at all times. Please never walk under equipment whilst someone is in the air and respect the space, equipment and others that are training. Please inform AcroAer Ltd and its instructors of any health problems which require caution or appropriate adaptive safety measures.

AcroAer Ltd and its instructors are not responsible for monitoring minors outside of class hours.

AcroAer Ltd and its instructors are not responsible for, and are in no case liable for damage or injury caused by or suffered by students during classes or travel. All students of aerial classes voluntarily release, forever discharge, and agree to indemnify AcroAer Ltd and its instructors from any and all claims, demands, or causes of action, which are in any way connected with their participation in aerial activity or their use of the equipment or facilities. AcroAer Ltd and its instructors reserves the right to change aerial classes. Registration for the aerial classes implies acceptance of these rules.

*Please note that we will contact you via mobile or email if there are any changes or cancellations to a class you are already registered in.

Disclaimer

I authorise my child (over 7 yrs unless otherwise agreed with AcroAer Ltd), to participate in aerial classes. I declare that my child has no medical, emotional or physical problems which might prevent them from safely participating in the aerial classes. I understand that every effort will be made to contact me in an event of an emergency requiring medical attention for my child. However, if I cannot be reached, I hereby authorise AcroAer Ltd and its instructors to transport my child to the nearest medical care facility and/or to secure necessary treatment for my child if he or she might require medical intervention during the classes. I certify that my child has not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my child’s participation in these activities.

AcroAer Ltd and its instructors are in no way responsible for the safekeeping of my child’s personal belongings while s/he attends class.

Neither you, your heirs, executors or legal representative(s) will sue or make any other claims of any kind whatsoever against AcroAer Ltd and its instructors for any personal injury, property damage/loss or wrongful death, whether caused by negligence or otherwise.

 

Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a world wide pandemic by the World Health Organisation (WHO). COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, the Department of Health recommends social distancing of 2 meters, regular hand hygiene and keeping social contacts at a minimum.

AcroAer Ltd has put in place preventative measures to reduce the spread of COVID-19 (please refer to COVID-19 Studio Policy). However, AcroAer Ltd cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending AcroAer classes could increase your risk and your child(ren)’s risk of contracting COVID-19. If you or your child(ren) are considered at higher risk from COVID-19 and are advised to cocoon by the Department of Health, we kindly request that you please do not enrol yourself or your child(ren) in AcroAer classes at this moment in time.

 

By signing this Agreement, I acknowledge the contagious nature to COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending AcroAer classes and that such exposure or infection may result in personal injury, illness, permanent disability and death. I understand that the risk of becoming exposed to or infected by COVID-19 at AcroAer may result from actions, omissions, or negligence of myself and others, including, but not limited to, AcroAer Instructors, students and their families.

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 of AcroAer classes (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless AcroAer Ltd ,its instructors, 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 AcroAer Ltd, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during or after participation in any AcroAer classes.

Today's Date: June 25, 2026 

First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
Information

Physical Activity Readiness Questionnaire (PAR-Q):
The following questions are for your child's health and safety and will help us identify any possible health problems that might be of concern when participating in aerial classes with AcroAer Ltd and its instructors. 

 

1) Has your child's doctor ever said that s/he have a heart condition and that s/he should only do physical activity recommended by a doctor?*
No
Yes
2) Does your child feel pain in their chest when they do physical activity?*
No
Yes
3) In the past month, has your child had chest pain when they were not doing physical activity?*
No
Yes
4) Does your child lose their balance because of dizziness or do they ever lose consciousness?*
No
Yes
5) Does your child have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?*
No
Yes
6) Is your child's doctor currently prescribing medication (for example, water pills) for your child's blood pressure or heart conditions?*
No
Yes

6a) What advice has your child's GP given in regards to exercise? *
7) Do you know of any other reason why your child should not do physical activity?*
No
Yes

7a) If yes, please explain

8) Please outline any other major illness, musculoskeletal injuries (such as fractures, muscle strains or joint strains, or disabilities, which may affect your participation. Please include dates and if you needed medical supervision. *

I HAVE READ, UNDERSTOOD AND COMPLETED THIS QUESTIONNAIRE. ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION. 

First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information

Physical Activity Readiness Questionnaire (PAR-Q):
The following questions are for your child's health and safety and will help us identify any possible health problems that might be of concern when participating in aerial classes with AcroAer Ltd and its instructors. 

 

1) Has your child's doctor ever said that s/he have a heart condition and that s/he should only do physical activity recommended by a doctor?*
No
Yes
2) Does your child feel pain in their chest when they do physical activity?*
No
Yes
3) In the past month, has your child had chest pain when they were not doing physical activity?*
No
Yes
4) Does your child lose their balance because of dizziness or do they ever lose consciousness?*
No
Yes
5) Does your child have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?*
No
Yes
6) Is your child's doctor currently prescribing medication (for example, water pills) for your child's blood pressure or heart conditions?*
No
Yes

6a) What advice has your child's GP given in regards to exercise? *
7) Do you know of any other reason why your child should not do physical activity?*
No
Yes

7a) If yes, please explain

8) Please outline any other major illness, musculoskeletal injuries (such as fractures, muscle strains or joint strains, or disabilities, which may affect your participation. Please include dates and if you needed medical supervision. *

I HAVE READ, UNDERSTOOD AND COMPLETED THIS QUESTIONNAIRE. ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION. 

Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information

Physical Activity Readiness Questionnaire (PAR-Q):
The following questions are for your child's health and safety and will help us identify any possible health problems that might be of concern when participating in aerial classes with AcroAer Ltd and its instructors. 

 

1) Has your child's doctor ever said that s/he have a heart condition and that s/he should only do physical activity recommended by a doctor?*
No
Yes
2) Does your child feel pain in their chest when they do physical activity?*
No
Yes
3) In the past month, has your child had chest pain when they were not doing physical activity?*
No
Yes
4) Does your child lose their balance because of dizziness or do they ever lose consciousness?*
No
Yes
5) Does your child have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?*
No
Yes
6) Is your child's doctor currently prescribing medication (for example, water pills) for your child's blood pressure or heart conditions?*
No
Yes

6a) What advice has your child's GP given in regards to exercise? *
7) Do you know of any other reason why your child should not do physical activity?*
No
Yes

7a) If yes, please explain

8) Please outline any other major illness, musculoskeletal injuries (such as fractures, muscle strains or joint strains, or disabilities, which may affect your participation. Please include dates and if you needed medical supervision. *

I HAVE READ, UNDERSTOOD AND COMPLETED THIS QUESTIONNAIRE. ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION. 

Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information

Physical Activity Readiness Questionnaire (PAR-Q):
The following questions are for your child's health and safety and will help us identify any possible health problems that might be of concern when participating in aerial classes with AcroAer Ltd and its instructors. 

 

1) Has your child's doctor ever said that s/he have a heart condition and that s/he should only do physical activity recommended by a doctor?*
No
Yes
2) Does your child feel pain in their chest when they do physical activity?*
No
Yes
3) In the past month, has your child had chest pain when they were not doing physical activity?*
No
Yes
4) Does your child lose their balance because of dizziness or do they ever lose consciousness?*
No
Yes
5) Does your child have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?*
No
Yes
6) Is your child's doctor currently prescribing medication (for example, water pills) for your child's blood pressure or heart conditions?*
No
Yes

6a) What advice has your child's GP given in regards to exercise? *
7) Do you know of any other reason why your child should not do physical activity?*
No
Yes

7a) If yes, please explain

8) Please outline any other major illness, musculoskeletal injuries (such as fractures, muscle strains or joint strains, or disabilities, which may affect your participation. Please include dates and if you needed medical supervision. *

I HAVE READ, UNDERSTOOD AND COMPLETED THIS QUESTIONNAIRE. ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION. 

Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information

Physical Activity Readiness Questionnaire (PAR-Q):
The following questions are for your child's health and safety and will help us identify any possible health problems that might be of concern when participating in aerial classes with AcroAer Ltd and its instructors. 

 

1) Has your child's doctor ever said that s/he have a heart condition and that s/he should only do physical activity recommended by a doctor?*
No
Yes
2) Does your child feel pain in their chest when they do physical activity?*
No
Yes
3) In the past month, has your child had chest pain when they were not doing physical activity?*
No
Yes
4) Does your child lose their balance because of dizziness or do they ever lose consciousness?*
No
Yes
5) Does your child have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?*
No
Yes
6) Is your child's doctor currently prescribing medication (for example, water pills) for your child's blood pressure or heart conditions?*
No
Yes

6a) What advice has your child's GP given in regards to exercise? *
7) Do you know of any other reason why your child should not do physical activity?*
No
Yes

7a) If yes, please explain

8) Please outline any other major illness, musculoskeletal injuries (such as fractures, muscle strains or joint strains, or disabilities, which may affect your participation. Please include dates and if you needed medical supervision. *

I HAVE READ, UNDERSTOOD AND COMPLETED THIS QUESTIONNAIRE. ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION. 

Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information

Physical Activity Readiness Questionnaire (PAR-Q):
The following questions are for your child's health and safety and will help us identify any possible health problems that might be of concern when participating in aerial classes with AcroAer Ltd and its instructors. 

 

1) Has your child's doctor ever said that s/he have a heart condition and that s/he should only do physical activity recommended by a doctor?*
No
Yes
2) Does your child feel pain in their chest when they do physical activity?*
No
Yes
3) In the past month, has your child had chest pain when they were not doing physical activity?*
No
Yes
4) Does your child lose their balance because of dizziness or do they ever lose consciousness?*
No
Yes
5) Does your child have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?*
No
Yes
6) Is your child's doctor currently prescribing medication (for example, water pills) for your child's blood pressure or heart conditions?*
No
Yes

6a) What advice has your child's GP given in regards to exercise? *
7) Do you know of any other reason why your child should not do physical activity?*
No
Yes

7a) If yes, please explain

8) Please outline any other major illness, musculoskeletal injuries (such as fractures, muscle strains or joint strains, or disabilities, which may affect your participation. Please include dates and if you needed medical supervision. *

I HAVE READ, UNDERSTOOD AND COMPLETED THIS QUESTIONNAIRE. ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION. 

Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information

Physical Activity Readiness Questionnaire (PAR-Q):
The following questions are for your child's health and safety and will help us identify any possible health problems that might be of concern when participating in aerial classes with AcroAer Ltd and its instructors. 

 

1) Has your child's doctor ever said that s/he have a heart condition and that s/he should only do physical activity recommended by a doctor?*
No
Yes
2) Does your child feel pain in their chest when they do physical activity?*
No
Yes
3) In the past month, has your child had chest pain when they were not doing physical activity?*
No
Yes
4) Does your child lose their balance because of dizziness or do they ever lose consciousness?*
No
Yes
5) Does your child have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?*
No
Yes
6) Is your child's doctor currently prescribing medication (for example, water pills) for your child's blood pressure or heart conditions?*
No
Yes

6a) What advice has your child's GP given in regards to exercise? *
7) Do you know of any other reason why your child should not do physical activity?*
No
Yes

7a) If yes, please explain

8) Please outline any other major illness, musculoskeletal injuries (such as fractures, muscle strains or joint strains, or disabilities, which may affect your participation. Please include dates and if you needed medical supervision. *

I HAVE READ, UNDERSTOOD AND COMPLETED THIS QUESTIONNAIRE. ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION. 

Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information

Physical Activity Readiness Questionnaire (PAR-Q):
The following questions are for your child's health and safety and will help us identify any possible health problems that might be of concern when participating in aerial classes with AcroAer Ltd and its instructors. 

 

1) Has your child's doctor ever said that s/he have a heart condition and that s/he should only do physical activity recommended by a doctor?*
No
Yes
2) Does your child feel pain in their chest when they do physical activity?*
No
Yes
3) In the past month, has your child had chest pain when they were not doing physical activity?*
No
Yes
4) Does your child lose their balance because of dizziness or do they ever lose consciousness?*
No
Yes
5) Does your child have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?*
No
Yes
6) Is your child's doctor currently prescribing medication (for example, water pills) for your child's blood pressure or heart conditions?*
No
Yes

6a) What advice has your child's GP given in regards to exercise? *
7) Do you know of any other reason why your child should not do physical activity?*
No
Yes

7a) If yes, please explain

8) Please outline any other major illness, musculoskeletal injuries (such as fractures, muscle strains or joint strains, or disabilities, which may affect your participation. Please include dates and if you needed medical supervision. *

I HAVE READ, UNDERSTOOD AND COMPLETED THIS QUESTIONNAIRE. ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION. 

Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information

Physical Activity Readiness Questionnaire (PAR-Q):
The following questions are for your child's health and safety and will help us identify any possible health problems that might be of concern when participating in aerial classes with AcroAer Ltd and its instructors. 

 

1) Has your child's doctor ever said that s/he have a heart condition and that s/he should only do physical activity recommended by a doctor?*
No
Yes
2) Does your child feel pain in their chest when they do physical activity?*
No
Yes
3) In the past month, has your child had chest pain when they were not doing physical activity?*
No
Yes
4) Does your child lose their balance because of dizziness or do they ever lose consciousness?*
No
Yes
5) Does your child have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?*
No
Yes
6) Is your child's doctor currently prescribing medication (for example, water pills) for your child's blood pressure or heart conditions?*
No
Yes

6a) What advice has your child's GP given in regards to exercise? *
7) Do you know of any other reason why your child should not do physical activity?*
No
Yes

7a) If yes, please explain

8) Please outline any other major illness, musculoskeletal injuries (such as fractures, muscle strains or joint strains, or disabilities, which may affect your participation. Please include dates and if you needed medical supervision. *

I HAVE READ, UNDERSTOOD AND COMPLETED THIS QUESTIONNAIRE. ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION. 

Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information

Physical Activity Readiness Questionnaire (PAR-Q):
The following questions are for your child's health and safety and will help us identify any possible health problems that might be of concern when participating in aerial classes with AcroAer Ltd and its instructors. 

 

1) Has your child's doctor ever said that s/he have a heart condition and that s/he should only do physical activity recommended by a doctor?*
No
Yes
2) Does your child feel pain in their chest when they do physical activity?*
No
Yes
3) In the past month, has your child had chest pain when they were not doing physical activity?*
No
Yes
4) Does your child lose their balance because of dizziness or do they ever lose consciousness?*
No
Yes
5) Does your child have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?*
No
Yes
6) Is your child's doctor currently prescribing medication (for example, water pills) for your child's blood pressure or heart conditions?*
No
Yes

6a) What advice has your child's GP given in regards to exercise? *
7) Do you know of any other reason why your child should not do physical activity?*
No
Yes

7a) If yes, please explain

8) Please outline any other major illness, musculoskeletal injuries (such as fractures, muscle strains or joint strains, or disabilities, which may affect your participation. Please include dates and if you needed medical supervision. *

I HAVE READ, UNDERSTOOD AND COMPLETED THIS QUESTIONNAIRE. ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION. 

Parent or Guardian's Email Address
Email*
Confirm Email*
Please tick this box if you wish to receive emails about classes, workshops and events
Release & Contact Form
Please tick this box if you consent to the use of your child's image being used for promotion and sharing on social media platforms, newsletters and website.
I agree
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*
Date of Birth
Information

Physical Activity Readiness Questionnaire (PAR-Q):
The following questions are for your child's health and safety and will help us identify any possible health problems that might be of concern when participating in aerial classes with AcroAer Ltd and its instructors. 

 

1) Has your child's doctor ever said that s/he have a heart condition and that s/he should only do physical activity recommended by a doctor?*
No
Yes
2) Does your child feel pain in their chest when they do physical activity?*
No
Yes
3) In the past month, has your child had chest pain when they were not doing physical activity?*
No
Yes
4) Does your child lose their balance because of dizziness or do they ever lose consciousness?*
No
Yes
5) Does your child have a bone or joint problem (for example, back, knee or hip) that could be made worse by a change in your physical activity?*
No
Yes
6) Is your child's doctor currently prescribing medication (for example, water pills) for your child's blood pressure or heart conditions?*
No
Yes

6a) What advice has your child's GP given in regards to exercise? *
7) Do you know of any other reason why your child should not do physical activity?*
No
Yes

7a) If yes, please explain

8) Please outline any other major illness, musculoskeletal injuries (such as fractures, muscle strains or joint strains, or disabilities, which may affect your participation. Please include dates and if you needed medical supervision. *

I HAVE READ, UNDERSTOOD AND COMPLETED THIS QUESTIONNAIRE. ANY QUESTIONS I HAD WERE ANSWERED TO MY FULL SATISFACTION. 

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!