Loading...

MOVE ACADEMIA INC

635 Middle Country Road, Coram, NY 11727 • (631) 846-1509 • dbatista1992@gmail.com

COOKING CLASS PARTICIPATION AGREEMENT, ASSUMPTION OF RISK, WAIVER, RELEASE & ALLERGEN DISCLOSURE

Class venue: Congregational UCC of Farmingville, 335 Horseblock Road, Farmingville, NY 11738 (the “Venue”)

DRAFT v2 — July 22, 2026 — venue confirmed — for review by New York counsel before use

PLEASE READ THIS ENTIRE DOCUMENT CAREFULLY BEFORE SIGNING. IT AFFECTS YOUR LEGAL RIGHTS AND INCLUDES AN ASSUMPTION OF RISK AND A RELEASE OF LIABILITY.

1. Parties; Program; Venue

This Cooking Class Participation Agreement, Assumption of Risk, Waiver, Release and Allergen Disclosure (this “Agreement”) is entered into between Move Academia Inc, a New York corporation with its principal place of business at 635 Middle Country Road, Coram, New York 11727 (“Move Academia”), and the participant identified below (the “Participant”). If the Participant is under 18 years of age, or is an adult for whom a parent holds legal decision-making authority or for whom a legal guardian has been appointed (including, without limitation, a guardian appointed under Article 17-A of the New York Surrogate's Court Procedure Act), this Agreement must be reviewed and signed by that parent or legal guardian (the “Guardian”), who agrees to this Agreement on the Participant's behalf and in the Guardian's individual capacity.

Move Academia's cooking classes are hands-on, instructor-led classes that teach food preparation, kitchen skills, kitchen safety, and nutrition. All fees paid for the class are paid for this instruction. Classes are held in a kitchen at the Venue, which Move Academia rents for this purpose. Participants prepare food under the instructor's supervision and may eat the food prepared during class.

2. Voluntary Participation; Assumption of Risk

The Participant's participation is entirely voluntary. The Participant (and Guardian, if applicable) understands that cooking involves inherent risks that cannot be eliminated even with careful instruction and supervision, including but not limited to: cuts and lacerations from knives (including safety knives) and other kitchen tools; burns and scalds from stoves, ovens, cookware, hot food, hot liquids, oil, and steam; fire; slips, trips, and falls, including on wet or greasy floors; strains from lifting or carrying; exposure to cleaning products; choking; foodborne illness; and allergic reactions to foods or ingredients.

THE PARTICIPANT (AND GUARDIAN, IF APPLICABLE) KNOWINGLY AND VOLUNTARILY ASSUMES ALL RISKS INHERENT IN PARTICIPATING IN A HANDS-ON COOKING CLASS AND IN CONSUMING FOOD PREPARED DURING CLASS, WHETHER KNOWN OR UNKNOWN. 


3. Allergen Disclosure; Food Consumption

Participants prepare and eat food during class. The kitchen handles common allergens — including, without limitation, peanuts, tree nuts, milk, eggs, wheat/gluten, soy, sesame, fish, and shellfish — and is a shared kitchen used by others. Despite reasonable care, Move Academia cannot guarantee that any food, surface, or piece of equipment is free of any allergen or free of cross-contact.

The Participant (or Guardian) agrees to fully and accurately disclose all of the Participant's food allergies, intolerances, and dietary restrictions in the allergy questions accompanying this Agreement, and to notify Move Academia promptly if they change. Participants with severe allergies must bring any prescribed emergency medication (for example, an epinephrine auto-injector) to every class, and remain responsible for deciding whether to taste or eat any dish. The Participant eats food prepared or served in class at the Participant's own risk. 


4. Kitchen Safety Rules

The Participant agrees to: follow the instructor's directions at all times; handle knives, appliances, and equipment only as instructed and only when authorized to do so; wear closed-toe shoes and tie back long hair; wash hands and follow food-safety practices as directed; keep clear of hot surfaces and equipment except as instructed; and immediately report any injury, spill, breakage, or unsafe condition to the instructor.

I agree to follow these Kitchen Safety Rules:

I Agree

5. Health Representations

The Participant (or Guardian) represents that the Participant is able to safely take part in a hands-on cooking class, and that the allergy and health questions accompanying this Agreement have been answered truthfully and completely. Move Academia's instructors are not medical professionals and do not provide medical or dietary advice, diagnosis, or treatment.

6. Release and Waiver of Liability

In consideration of being permitted to participate in the cooking class, and to the fullest extent permitted by applicable law, the Participant (and Guardian, individually and on the Participant's behalf) hereby releases, waives, and forever discharges: (a) Move Academia Inc and its owners, officers, directors, employees, instructors, independent contractors, agents, and representatives; and (b) the Venue's owner and operator and their respective officers, directors, employees, members, volunteers, and agents (collectively, the “Released Parties”), from any and all claims, demands, causes of action, damages, losses, costs, and expenses (including reasonable attorneys' fees) arising out of or related to the Participant's participation in a cooking class or the Participant's consumption of food prepared or served in class, including claims based on the ordinary negligence of any Released Party.

Nothing in this Agreement releases any party from liability for gross negligence, recklessness, or intentional misconduct, and nothing in this Agreement waives any right that cannot be waived under applicable law. If any portion of this Section is held invalid or unenforceable, it shall be limited or severed only to the minimum extent necessary, and the remainder of this Agreement — including the assumption of risk in Section 2 and the allergen provisions in Section 3 — shall remain in full force and effect. 


7. Indemnification; Property

The Participant (and Guardian) agrees to indemnify and hold harmless the Released Parties from and against any claim, loss, damage, or expense (including reasonable attorneys' fees) arising out of the Participant's own acts or omissions, the Participant's violation of the Kitchen Safety Rules or instructor directions, or any breach of the representations made in this Agreement. The Participant (and Guardian) is responsible for damage to the Venue's property or equipment caused by the Participant's misuse or failure to follow instructions.

8. Medical Emergency Authorization

If the Participant becomes ill or is injured during a class, the Participant (and Guardian) authorizes Move Academia to administer or obtain basic first aid and, if reasonably necessary, to contact emergency medical services and consent to emergency medical treatment and transportation on the Participant's behalf until the Guardian or the emergency contact listed below can be reached. All costs of medical care and transportation are the responsibility of the Participant and/or Guardian. 


9. Photo & Video Release (Optional)

Move Academia occasionally photographs and video-records classes and events for marketing purposes, such as flyers, its website, and social media. This consent is optional, and declining it does not affect the Participant's ability to attend. Consent may be revoked at any time by written notice to Move Academia (revocation applies to future uses only). If consent is given, the Participant (and Guardian) grants Move Academia the right to use the Participant's image, likeness, and voice in Move Academia's marketing materials, without compensation.

10. Term

This Agreement takes effect on the date signed and remains in effect for twelve (12) months, covering each cooking class and class series in which the Participant enrolls during that period, whether a single event or a recurring program. If the Participant is a minor, this Agreement terminates as to future classes when the Participant turns 18, at which point the Participant must sign a new Agreement as an adult.

11. General Provisions

This Agreement is governed by the laws of the State of New York. Any dispute arising out of this Agreement or the Participant's participation shall be brought exclusively in the state courts located in Suffolk County, New York. If any provision of this Agreement is held invalid, the remaining provisions remain in full force and effect. This Agreement is the entire agreement between the parties regarding its subject matter and supersedes any prior understandings on that subject. The parties agree that this Agreement may be completed, signed, and delivered electronically (including through the Smartwaiver platform), and that an electronic signature has the same force and effect as an original ink signature.

ACKNOWLEDGMENT AND SIGNATURE

I have read this entire Agreement, I understand it, and I sign it freely and voluntarily. I acknowledge that I have had the opportunity to ask questions before signing.

A. ADULT PARTICIPANT (age 18 or older, signing for yourself):

B. PARENT OR LEGAL GUARDIAN — complete this section if the Participant is under 18, OR is an adult for whom you are the parent with legal authority or the court-appointed legal guardian

By signing below, I represent and warrant that I am the Participant's parent or legal guardian with full legal authority to sign this Agreement on the Participant's behalf, and I agree to this Agreement both on the Participant's behalf and in my individual capacity.

Date: September 9, 2026

First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
Information
Does the participant have ANY food allergies, intolerances, or dietary restrictions?*
No
Yes

List ALL food allergies, intolerances, and dietary restrictions in detail (write NONE if none).
If the participant has a severe allergy: will they bring prescribed emergency medication (e.g., EpiPen) to every class?*

9.  Photo & Video Release (Optional)

Move Academia occasionally photographs and video-records classes and events for marketing purposes, such as flyers, its website, and social media. This consent is optional, and declining it does not affect the Participant's ability to attend. Consent may be revoked at any time by written notice to Move Academia (revocation applies to future uses only). If consent is given, the Participant (and Guardian) grants Move Academia the right to use the Participant's image, likeness, and voice in Move Academia's marketing materials, without compensation.

Photo/Video consent (Section 9): Do you consent to Move Academia using the participant's image in marketing?”*
NO, I do not consent
YES, I consent
Who is completing this waiver?*
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Does the participant have ANY food allergies, intolerances, or dietary restrictions?*
No
Yes

List ALL food allergies, intolerances, and dietary restrictions in detail (write NONE if none).
If the participant has a severe allergy: will they bring prescribed emergency medication (e.g., EpiPen) to every class?*

9.  Photo & Video Release (Optional)

Move Academia occasionally photographs and video-records classes and events for marketing purposes, such as flyers, its website, and social media. This consent is optional, and declining it does not affect the Participant's ability to attend. Consent may be revoked at any time by written notice to Move Academia (revocation applies to future uses only). If consent is given, the Participant (and Guardian) grants Move Academia the right to use the Participant's image, likeness, and voice in Move Academia's marketing materials, without compensation.

Photo/Video consent (Section 9): Do you consent to Move Academia using the participant's image in marketing?”*
NO, I do not consent
YES, I consent
Who is completing this waiver?*
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Does the participant have ANY food allergies, intolerances, or dietary restrictions?*
No
Yes

List ALL food allergies, intolerances, and dietary restrictions in detail (write NONE if none).
If the participant has a severe allergy: will they bring prescribed emergency medication (e.g., EpiPen) to every class?*

9.  Photo & Video Release (Optional)

Move Academia occasionally photographs and video-records classes and events for marketing purposes, such as flyers, its website, and social media. This consent is optional, and declining it does not affect the Participant's ability to attend. Consent may be revoked at any time by written notice to Move Academia (revocation applies to future uses only). If consent is given, the Participant (and Guardian) grants Move Academia the right to use the Participant's image, likeness, and voice in Move Academia's marketing materials, without compensation.

Photo/Video consent (Section 9): Do you consent to Move Academia using the participant's image in marketing?”*
NO, I do not consent
YES, I consent
Who is completing this waiver?*
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Does the participant have ANY food allergies, intolerances, or dietary restrictions?*
No
Yes

List ALL food allergies, intolerances, and dietary restrictions in detail (write NONE if none).
If the participant has a severe allergy: will they bring prescribed emergency medication (e.g., EpiPen) to every class?*

9.  Photo & Video Release (Optional)

Move Academia occasionally photographs and video-records classes and events for marketing purposes, such as flyers, its website, and social media. This consent is optional, and declining it does not affect the Participant's ability to attend. Consent may be revoked at any time by written notice to Move Academia (revocation applies to future uses only). If consent is given, the Participant (and Guardian) grants Move Academia the right to use the Participant's image, likeness, and voice in Move Academia's marketing materials, without compensation.

Photo/Video consent (Section 9): Do you consent to Move Academia using the participant's image in marketing?”*
NO, I do not consent
YES, I consent
Who is completing this waiver?*
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Does the participant have ANY food allergies, intolerances, or dietary restrictions?*
No
Yes

List ALL food allergies, intolerances, and dietary restrictions in detail (write NONE if none).
If the participant has a severe allergy: will they bring prescribed emergency medication (e.g., EpiPen) to every class?*

9.  Photo & Video Release (Optional)

Move Academia occasionally photographs and video-records classes and events for marketing purposes, such as flyers, its website, and social media. This consent is optional, and declining it does not affect the Participant's ability to attend. Consent may be revoked at any time by written notice to Move Academia (revocation applies to future uses only). If consent is given, the Participant (and Guardian) grants Move Academia the right to use the Participant's image, likeness, and voice in Move Academia's marketing materials, without compensation.

Photo/Video consent (Section 9): Do you consent to Move Academia using the participant's image in marketing?”*
NO, I do not consent
YES, I consent
Who is completing this waiver?*
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Does the participant have ANY food allergies, intolerances, or dietary restrictions?*
No
Yes

List ALL food allergies, intolerances, and dietary restrictions in detail (write NONE if none).
If the participant has a severe allergy: will they bring prescribed emergency medication (e.g., EpiPen) to every class?*

9.  Photo & Video Release (Optional)

Move Academia occasionally photographs and video-records classes and events for marketing purposes, such as flyers, its website, and social media. This consent is optional, and declining it does not affect the Participant's ability to attend. Consent may be revoked at any time by written notice to Move Academia (revocation applies to future uses only). If consent is given, the Participant (and Guardian) grants Move Academia the right to use the Participant's image, likeness, and voice in Move Academia's marketing materials, without compensation.

Photo/Video consent (Section 9): Do you consent to Move Academia using the participant's image in marketing?”*
NO, I do not consent
YES, I consent
Who is completing this waiver?*
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Does the participant have ANY food allergies, intolerances, or dietary restrictions?*
No
Yes

List ALL food allergies, intolerances, and dietary restrictions in detail (write NONE if none).
If the participant has a severe allergy: will they bring prescribed emergency medication (e.g., EpiPen) to every class?*

9.  Photo & Video Release (Optional)

Move Academia occasionally photographs and video-records classes and events for marketing purposes, such as flyers, its website, and social media. This consent is optional, and declining it does not affect the Participant's ability to attend. Consent may be revoked at any time by written notice to Move Academia (revocation applies to future uses only). If consent is given, the Participant (and Guardian) grants Move Academia the right to use the Participant's image, likeness, and voice in Move Academia's marketing materials, without compensation.

Photo/Video consent (Section 9): Do you consent to Move Academia using the participant's image in marketing?”*
NO, I do not consent
YES, I consent
Who is completing this waiver?*
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Does the participant have ANY food allergies, intolerances, or dietary restrictions?*
No
Yes

List ALL food allergies, intolerances, and dietary restrictions in detail (write NONE if none).
If the participant has a severe allergy: will they bring prescribed emergency medication (e.g., EpiPen) to every class?*

9.  Photo & Video Release (Optional)

Move Academia occasionally photographs and video-records classes and events for marketing purposes, such as flyers, its website, and social media. This consent is optional, and declining it does not affect the Participant's ability to attend. Consent may be revoked at any time by written notice to Move Academia (revocation applies to future uses only). If consent is given, the Participant (and Guardian) grants Move Academia the right to use the Participant's image, likeness, and voice in Move Academia's marketing materials, without compensation.

Photo/Video consent (Section 9): Do you consent to Move Academia using the participant's image in marketing?”*
NO, I do not consent
YES, I consent
Who is completing this waiver?*
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Does the participant have ANY food allergies, intolerances, or dietary restrictions?*
No
Yes

List ALL food allergies, intolerances, and dietary restrictions in detail (write NONE if none).
If the participant has a severe allergy: will they bring prescribed emergency medication (e.g., EpiPen) to every class?*

9.  Photo & Video Release (Optional)

Move Academia occasionally photographs and video-records classes and events for marketing purposes, such as flyers, its website, and social media. This consent is optional, and declining it does not affect the Participant's ability to attend. Consent may be revoked at any time by written notice to Move Academia (revocation applies to future uses only). If consent is given, the Participant (and Guardian) grants Move Academia the right to use the Participant's image, likeness, and voice in Move Academia's marketing materials, without compensation.

Photo/Video consent (Section 9): Do you consent to Move Academia using the participant's image in marketing?”*
NO, I do not consent
YES, I consent
Who is completing this waiver?*
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Does the participant have ANY food allergies, intolerances, or dietary restrictions?*
No
Yes

List ALL food allergies, intolerances, and dietary restrictions in detail (write NONE if none).
If the participant has a severe allergy: will they bring prescribed emergency medication (e.g., EpiPen) to every class?*

9.  Photo & Video Release (Optional)

Move Academia occasionally photographs and video-records classes and events for marketing purposes, such as flyers, its website, and social media. This consent is optional, and declining it does not affect the Participant's ability to attend. Consent may be revoked at any time by written notice to Move Academia (revocation applies to future uses only). If consent is given, the Participant (and Guardian) grants Move Academia the right to use the Participant's image, likeness, and voice in Move Academia's marketing materials, without compensation.

Photo/Video consent (Section 9): Do you consent to Move Academia using the participant's image in marketing?”*
NO, I do not consent
YES, I consent
Who is completing this waiver?*
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Emergency Contact's Relation to Participant
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
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*
Last Name*
Relationship*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Information
Does the participant have ANY food allergies, intolerances, or dietary restrictions?*
No
Yes

List ALL food allergies, intolerances, and dietary restrictions in detail (write NONE if none).
If the participant has a severe allergy: will they bring prescribed emergency medication (e.g., EpiPen) to every class?*

9.  Photo & Video Release (Optional)

Move Academia occasionally photographs and video-records classes and events for marketing purposes, such as flyers, its website, and social media. This consent is optional, and declining it does not affect the Participant's ability to attend. Consent may be revoked at any time by written notice to Move Academia (revocation applies to future uses only). If consent is given, the Participant (and Guardian) grants Move Academia the right to use the Participant's image, likeness, and voice in Move Academia's marketing materials, without compensation.

Photo/Video consent (Section 9): Do you consent to Move Academia using the participant's image in marketing?”*
NO, I do not consent
YES, I consent
Who is completing this waiver?*
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!