(256) 760-0056 | lesley.allegrodance@gmail.com

1507 N. Wood Ave. Florence, AL, 35630

 

 

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Studio Liability Release
ALLEGRO DANCE & FITNESS LIABILITY WAIVER
You must sign the Agreement of Release and Waiver of Liability form before participating in Dance and Fitness classes. By signing this form, you confirm that you or your child is physically fit and you or your child has no medical condition(s) that would prevent you or your child in participating in the Dance and Fitness classes.

AGREEMENT OF RELEASE AND WAIVER OF LIABILITY This agreement is by and between the Allegro Dance Arts, LLC. facility, its owner, instructors, and the individual whose name is printed and signed below. Your head instructor, Lesley Corrigan, recommends that you consult your physician before starting any exercise program. Please be aware that when registering for Dance and Fitness classes, you will be waiving and releasing all claims for injuries you or your child might sustain from participating in these classes taught at Allegro Dance Arts, LLC. I ___________________________________________, hereby agree to the following: I have or my child has registered for class(es) at Allegro Dance Arts, LLC. I recognize that this activity requires physical exertion that may be strenuous and may cause physical injury and even death. And I am or my child is voluntarily participating in this activity. I hereby agree to expressly assume and accept any and all risk of injury and/or death. I understand that it is my responsibility to consult with a physician prior to and regarding my or my child’s participation in Dance and Fitness classes. I represent and warrant that I am, or my child is physically fit and I or my child has no medical condition that would prevent my or my child’s full participation in the Dance and Fitness classes. I acknowledge that my or my child’s enrollment and subsequent participation is purely voluntary and in no way mandated by the instructor. In consideration of being permitted to participate in Dance and Fitness classes, I agree to assume full responsibility for any risk, injuries or damages, known or unknown, which I or my child may incur as a result of participating in these classes. These conditions may include, but are not limited to, heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration, injuries to knees, injuries to back, injuries to foot, or any other illness or soreness that I or my child may incur, including death. In further consideration of being permitted to participate in the Dance and Fitness classes, I knowingly, voluntarily and expressly waive any claims, demands, and causes of action I may have against Lesley Corrigan, or the Allegro Dance Arts LLC. facility, or its owners, employees and instructors for injuries, damages, including death, that I or my child may sustain now or in the future as a result of participating in the Dance and Fitness classes or being on the premises. I, my heirs or legal representatives forever release, waive, discharge and covenant not to sue Lesley Corrigan, Allegro Dance Arts LLC., or its owners or employees or instructors for any injury or death caused by my or my child’s voluntary participation in any Dance and Fitness classes at Allegro Dance Arts, LLC. or being on the premises. In the event of any emergency, I authorize medical attention from any licensed hospital, physician and/or medical personnel any treatment deemed necessary for my or my child’s immediate care and agree that I will be responsible for payment of any and all medical services rendered. Therefore, each person registering themselves or family members should review their own health insurance policy for coverage. It must be noted that the absence of heath insurance coverage does not make the fitness instructor responsible for payment of any medical expenses. I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above. This agreement remains in effect for as long as I or my child participates in any dance and fitness classes instructed by Lesley Corrigan or any other instructor employed at Allegro Dance Arts, LLC.
 
ADDITIONAL AGREEMENTS: I agree that my image may be used for promotional purposes in print or on the internet if I’m photographed or video recorded at the studio. I agree that if I am unable to attend a fitness class I booked online, and I do not cancel my reservation at least one hour before the reserved class’s start time, I will lose a visit and my account will be charged a $5 late cancel fee.
 
Signature of Participant _____________________________________________________ Date ____________________
As legal guardian of ______________________________________________________________, I consent to the above.
Signature of Parent/Guardian of participant ______________________________________________________________
Date ____________________