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PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK

In consideration of the services of Circus Up, Inc. 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 Circus Up), I hereby agree to release, indemnify, and discharge Circus Up, Inc. on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows.


1.  I acknowledge that my participation in circus arts training and instruction, including trapeze, aerial fabric and other 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 risk include, among other things: exposing its participants to the potential for slips and falls and falling; rope burns; pinches; scrapes, twists and jolts that could result in scratches, bruises, sprains, lacerations, fractures, concussions, or even severe life threatening hazards; strains, sprains, 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, Circus Up employees and volunteers have difficult jobs to perform.  They seek safety, but they are not infallible.  They might be unaware of participants' fitness, medical conditions, or abilities.  They might misjudge the weather or other environmental conditions.  They may give incomplete warnings or instructions, and the equipment being used might malfunction.


2. I expressly agree and promise to accept and assume all of the risk existing in this activity.  My participation in this activity is purely voluntary, and I elect to participate in spite of the risks.


3. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Circus Up 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 Circus Ups equipment or facilities, including any such claims which allege negligent acts or omissions of Circus Up.


4. Should Circus Up or anyone acting on their behalf, be required to incur attorneys fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.


5. 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 conditions I may have. 


6. In the event that I file a lawsuit against Circus Up, I agree to do so solely in the commonwealth of Massachusetts, and I further agree that the substantive law of Massachusetts shall apply in that action without regard to the conflict of law rules of that commonwealth.  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.


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 Circus Up 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.


First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
First Participant's Emergency Contact

Name of emergency contact *

Phone number of emergency contact *
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Emergency Contact

Name of emergency contact *

Phone number of emergency contact *
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Emergency Contact

Name of emergency contact *

Phone number of emergency contact *
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Emergency Contact

Name of emergency contact *

Phone number of emergency contact *
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Emergency Contact

Name of emergency contact *

Phone number of emergency contact *
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Emergency Contact

Name of emergency contact *

Phone number of emergency contact *
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Emergency Contact

Name of emergency contact *

Phone number of emergency contact *
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Emergency Contact

Name of emergency contact *

Phone number of emergency contact *
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Emergency Contact

Name of emergency contact *

Phone number of emergency contact *
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Emergency Contact

Name of emergency contact *

Phone number of emergency contact *
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information and news 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. PARENT’S OR GUARDIAN’S ADDITIONAL INDEMNIFICATION (Must be completed for participants under the age of 18) In consideration of my minor child/children being permitted by CIRCUS UP to participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless CIRCUS UP from any and all claims which are brought by, or on behalf of Minor(s), and which are in any way connected with such use or participation by Minor(s).


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*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Emergency Contact

Name of emergency contact *

Phone number of emergency contact *
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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