355 Cherrington Rd, Westerville, OH 43081

614-901-8325 | 355 Cherrington Rd, Westerville, OH 43081 | [email protected]

Acknowledgement of Risk, Waiver of Liability, and Media Release Form


By the very nature of the activity, dancing is a risk of physical injury. No matter how careful the student and instructor, the risk cannot be eliminated. Reduced, yes, but never eliminated.
I understand and accept that risk.
In consideration of my participation, I hereby release and covenant not-to-sue Leap of Faith Dance Company, Leap of Faith Dance Company members/officers, and any employees, teachers, coaches, or agents whether paid or volunteer, from any and all present and future claims resulting from ordinary negligence on the part of Leap of Faith Dance Company; or others listed for property damage or personal injury, arising as a result of my child’s engaging in or receiving instruction in dance, or any activities incidental thereto, wherever, whenever, or however the same may occur. As the parent or legal guardian of the aforementioned person, I hereby agree to individually protect for the possible future medical expenses that may be incurred by my child as a result of any injury sustained while participating in any program of instruction or performance at, for, or under the direction of Leap of Faith Dance Company.
I hereby consent to the photographing of the aforementioned person and the recording of the aforementioned person’s voice and the use of these photographs and/or singularly or in conjunction with other photographs and/or recordings for advertising, publicity, commercial or other business purposes. I hereby release Leap of Faith Dance Company, and any of its associated or affiliated companies, their directors, officers, agents, employees and customers, and appointed advertising agencies, their directors, officer, agents and employees from all claims of every kind on an account of such use.
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing as well as strict cleaning protocols. Leap of Faith Dance Company (“LOFDC”) has put in place many preventative measures to reduce the spread of COVID-19; however, LOFDC cannot guarantee that you or your child(ren) will not become infected with COVID-19 by entering our facility.
I further acknowledge, understand, appreciate and agree that my participation may result in possible exposure to and illness from infectious diseases, including, but not limited to, MRSA, Influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releases or others, and assume full responsibility for my participation and exposure. I hereby release, covenant not to sue, discharge, and hold harmless LOFDC, its employees, 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.

Acknowledgement

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