Liability Waiver and Release Form
In consideration of the services of Akasha Aerial Arts 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 Akasha), I hereby agree to release, indemnify, and discharge Akasha, 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 aerial arts training and instruction, including lyra hoop, aerial fabric, pole 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; silk 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, Akasha employees and volunteers have difficult jobs to perform. They seek safety, but they are not infallible. They might be unaware of participant’s 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 Akasha 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 Akasha’s equipment or facilities, including any such claims which allege negligent acts or omissions of Akasha.
4. Should Akasha 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 conditions I may have.
6. In the event that I file a lawsuit against Akasha, I agree to do so solely in the state of Washington State, and I further agree that the substantive law of Washington 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 Akasha 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.
Signature of Participant_____________________________________
Signature of Parent/Guardian_________________________________
Print Name(Student)_______________________________________DOB____/_____/_____
Address__________________________________________________________
City/State_____________________________________________ Zip___________
Phone__________________________________
E-mail address___________________________________________________________ Date________________
I do NOT give permission for my/my child’s photo to be used for promotional purposes ☐
PARENT’S OR GUARDIAN’S ADDITIONAL INDEMNIFICATION
(Must be completed for participants under the age of 18)
In consideration of ____________________________________________________________________(print minor’s Name) (“Minor”) being permitted by Akasha to participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless Akasha from any and all claims which are brought by, or on behalf of Minor, and which are in any way connected with such use or participation by Minor.
Parent or Guardian:____________________________________
Print Name:__________________________________________ Date:_________________
Covid-19 Waiver
Safety First Partnership Agreement and Assumption of Risk
**Please initial each statement**
Each time you are coming into Akasha, you agree to the following:
___To the best of my knowledge, I/my child:_________________________ Have not shown symptoms of COVID-19 in the past 14 days. According to the Center for the Disease Control, below are symptoms: ● Cough ● Shortness of breath or difficulty breathing ● Fever ● Chills ● Repeated shaking with chills ● Muscle pain ● Headache ● Sore throat ● New loss of taste or smell
___ I have not been in contact with anyone who has tested positive for COVID-19 or shown any of the above symptoms in the past 14 days.
___ I have worn a protective mask when in public situations where social distancing is not consistently possible.
___ I understand that I could be a carrier of COVID-19 and be asymptomatic.
___ I understand that I could contract COVID-19 from an asymptomatic person at our facility or a contaminated surface.
___ I am fully aware of the facility's safety procedures to prevent the spread of COVID-19 and will follow these procedures.
___ I agree to inform the studio/school immediately if I have developed symptoms within a two week period of being in the studio, or if I have learned that I have been in direct contact with someone who has later tested positive for the coronavirus within the same two week period or traveled in the past 14 days.
___ I understand that if I willfully and intentionally violate the stated hygiene rules in our facility, the facility has the right to suspend me without a refund.
___ I Agree to inform the studio/school immediately if I learn that any of the above information changes or I obtain new information.
Print name:________________________
Student/Parent/Gaurdian Signature:_________________________
Date:_____________________________
Cancellation and Refund Policy
If a client has purchased a package, there will be no refunds on unused trainings. Most packages expire after three months.
There will be no refunds if a student or parent cancels within 24 hours.
You are considered late and a no show if you arrive more than 15 after the start of training. Your training spot will be given to the next person on the waitlist. There will be no refunds if a student cannot attend class because they are past their 15 minute window.
All private clients must cancel a lesson no less than 24 hours in advance or there will be a $30 cancellation fee. 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 Akasha Aerial Arts and Akasha LLC 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.
Participant's Name or Legal Guardian of Participant: ____________________________________________ Signature of Participant / Legal Guardian: ____________________________________________
Date:____________________________