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Waiver Form for Sitka Cirque


If you are looking to register for weekly classes, you may be filling out the wrong form. Email sitkacirque@gmail.com with questions

Terms and Conditions (please initial in space provided)

Cancellation/Refund/Transfer Policy: I understand that once payment is made all sales are final. Sitka Cirque LLC does not issue refunds except in the case of a medical emergency or if a student leaves town. In addition, funds cannot be transferred to another account. Covid quarantine is not considered a medical emergency. 

Rules and Regulations: Member acknowledges that Cirque operates under rules and regulations established for the safety and protection of its members and agrees to be bound by such rules and regulations as well by the rules and regulations subsequently approved and posted or otherwise published by Cirque. Such rules and regulations in effect from time to time are incorporated into this agreement by reference. Facilities, equipment, hours, service regulations and policies are subject to change from time to time, without prior notice, in the sole discretion of Sitka Cirque LLC. Members agree to accept such reasonable changes as a condition of membership. Member additionally recognizes:

A. Under no circumstances shall members use the equipment in any manner not authorized by Sitka Cirque LLC.

B. Sitka Cirque LLC shall not be responsible for any lost or stolen items.

C. Proper attire will be worn at all times. Jewelry & watches must be removed. Piercing must be removed or covered with tape. Hair that is long enough to cover the face must be secured back. Clothing must be form fitting and cover the back, armpits, abdomen and area behind the knees. No zippers snaps or buckles on clothing. Failure to comply with these safety rules may result in a student being asked to sit out.

D. If a student is late and misses warmups they will be asked to sit and watch class.

Release and Waiver of Liability. Waiver of liability must be on file with Sitka Cirque LLC. 

Prohibited Activities: Alcohol, drugs, and smoking are prohibited within the facility. Members agree not to use the facility or engage in any activity at Sitka Cirque LLC while under the influence of drugs, alcohol or medication that may impair members ability. No weapons of any kind are allowed. 

Binding Effect. This agreement shall be binding upon, inure to the benefit of, and be enforceable by the parties hereto and their respective successors and assigns. 

Suspension and Termination: I understand that Sitka Cirque LLC may suspend or terminate my membership at any time, in it sole and absolute discretion for non-payment of membership fees or for any violation of any of Sitka Cirque LLC’s policies and procedures, and that in doing so, Sitka Cirque LLC assumes no further liability to adhere to the terms of this agreement. 

Acceptance of Terms. As a participant/parent I understand that the student is entitled to use the facility within the scope of the membership that I have selected, and that I am obligated to pay my dues and fees regardless of whether or not the student attends classes. I agree to promptly update Sitka Cirque LLC of any change in my credit card information. 

Photographs: Sitka Cirque LLC have permission to use photographs of myself or my child online or for any media/advertising. 


 I HAVE READ SITKA CIRQUE LLC COVID PLAN. I UNDERSTAND AND ACCEPT THESE TERMS.   


I have read and understood Sitka Cirque’s Studio Rules. 


I certify that I have read the foregoing membership agreement and that by signing below I acknowledge that I understand and agree to be bound by all the terms and conditions hereof. I further acknowledge that a fully executed copy of this membership agreement has been provided to me.

Signature of Cirque student or guardian:

Date: December 22, 2024



WAIVER FORM PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK

In consideration of the services of Sitka Cirque LLC, their agents, owners, officers, volunteers, employees, and all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as "SC"), I hereby agree to release, indemnify, and discharge SC, 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, aerial arts, dance, and gymnastics training and instruction activities 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; musculoskeletal injuries including head, neck and back injuries; transmissible pathogen or disease; my own physical condition, and the physical exertion associated with this activity; the negligence of other participants, or other persons who may be present. Traveling to and from shows, meets and exhibitions raises the possibility of any manner of transportation accidents.

Furthermore, SC personnel 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 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 risks 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 SC 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 SC's equipment or facilities, including any such claims which allege negligent acts or omissions of SC.

4. Should SC 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.

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 condition I may have.

6. In the event that I file a lawsuit against SC, I agree to do so solely in the state of Alaska, 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.

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 SC on the basis of any claim from which I have released them herein. I also agree that this document is valid for subsequent visits and participation at SC. 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.

Date: December 22, 2024

207 Smith Street ● 907 623 0751 ● sitkacirque@gmail.com


Find us online website: sitkacirque.com ● facebook & instagram: sitka cirque


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*

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*

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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