I am not aware of any medical condition I have that should preclude me from participating in dance and / or aerial activities. I understand there is a definitive risk of injury associated with dancing and/or performing aerials, and that such injuries include, but are not limited to bruises, dislocations, broken bones, torn or damaged muscles and ligaments, paralysis, and even death. I understand that such injuries may be caused in whole or in party by myself, or by the actions or inactions of other students or instructors.
In consideration of being accepted for dance and or aerial instruction by the Center for American Dance (d.b.a. Joffrey Ballet School), and in further consideration of the expertise and achievements of instructors at the Center for American Dance (d.b.a. Joffrey Ballet School), and the limited number of students that may be accepted by the Center for American Dance (d.b.a. Joffrey Ballet School), I agree to all of the following, which shall bind me, and also my heirs, assigns executors, and administrators:
- A. I/My child agree(s) to immediately stop performing any activity if I/they feel any pain, dizziness, light-headedness, or any other symptoms, and to immediately report those symptoms to the instructor. I/they also agree to carefully follow the instructors’ directions, to ask for additional directions if I do not understand any particular activity, and to immediately stop any activity which I/they believe I am/they are not competent or confident enough to perform.
- B. To the fullest extent permitted by law, I/they agree and represent that I/they assume the risk and responsibility for any and all injuries to myself that I/they sustain while performing any dance or aerial activities, including any and all costs and damages that are a consequence of such injuries, and whether such injuries, costs and damages were caused in whole or in part by the Center for American Dance’s (d.b.a. Joffrey Ballet School) students, or instructors, or the Artistic/Program Director.
- C. To the fullest extent permitted by law, I agree to defend, indemnify and hold harmless the Center for American Dance (d.b.a. Joffrey Ballet School), the Artistic/Program Director, and their instructors, agents, employees, contractors, clients, and students, from and against all claims, costs, damages, losses and expenses, including but not limited to attorney’s fees, arising out of or resulting from my performance or other participation in any dance or aerial activities, regardless of whether or not such claim, cost, damage, loss or expense, was caused in part by a party indemnified hereunder.
I am not aware of any medical condition I have or am suffering from that should preclude me from participating in dance activities. I understand there is a definitive risk of injury associated with dancing and that such injuries include, but are not limited to bruises, dislocations, broken bones, torn or damaged muscles and ligaments, paralysis, and even death. I understand that such injuries may be caused in whole or in partly by myself, or by the actions or inactions of other students or instructors. I also agree to carefully follow the instructors’ directions, to ask for additional directions if I do not understand any particular activity, and to immediately stop any activity which I believe I am not competent or confident enough to perform.
I understand that in connection with the COVID-19 pandemic, Center for American Dance Inc. d/b/a Joffrey Ballet School is requiring all individuals who enter onto Joffrey premises, take a class at a Joffrey location or via remote learning, or otherwise participate in any Joffrey event to execute this Waiver and Release of Liability, acknowledging the risks related to COVID-19 as well as such other injuries that may result from such activities.
I understand and accept that dance education sometimes requires hands-on instruction as well as verbal instruction. I accept that instructors may correct dancers by touching their arms, legs, feet, hips, back and head to move them in the correct position. I further understand and accept that it is normal and usual for students to touch each other during dance class, including touching each other’s arms, legs, feet, hips, back and head, particularly, but not limited to, classes involving partnering and improvisation. I acknowledge and accept that this is a common standard in dance instruction and understand that it is the student’s responsibility to communicate clearly with the student’s teacher, other students, and/or the director if any form of touch is unacceptable to the student.
The waiver, release and other representations and covenants set forth herein are given in consideration for Joffrey permitting me and/or my child or ward to enter onto Joffrey premises, take a class at a Joffrey location or via remote learning, or otherwise participate in any Joffrey event.
Acceptance of Risk; Release; Indemnification. I am fully aware that there are a number of risks associated with me and/or my child or ward entering onto Joffrey premises, taking a class at a Joffrey location or via remote learning, and/or participating in any Joffrey event during the COVID-19 pandemic or at any time, including without limitation: (a) I and/or my child or ward and/or our family and/or other third parties with whom we may come into contact could contract COVID-19 or other diseases (including but not limited to influenza or legionnaires disease), which could result in a serious medical condition and/or require medical treatment in a hospital, and which may result in permanent harm and/or possibly lead to death; and (b) I and/or my child or ward will be subject to normal risks associated with engaging in physical activity such as physical injuries, including without limitation, from slips or falls, muscle pulls, broken bones, or such other serious injury, or loss or damage to personal property, or even death. On behalf of myself and/or my child or ward and our heirs, successors and assigns, I knowingly and freely, assume all such risks, both known and unknown (including but not limited to contracting COVID-19), relating to my and/or my child’s or ward’s entering onto Joffrey premises, taking a class at a Joffrey location or via remote learning, and/or participating in any Joffrey event, and I hereby now and forever release, waive, relinquish, and discharge Joffrey, along with their officers, directors, shareholders/owners, managers, officials, trustees, agents, employees, Greenwich Village Ballet LLC and the employees of Greenwich Village Ballet LLC, or other representatives, and their successors and assigns (collectively, the “Joffrey Parties”), from any and all claims, demands, liabilities, rights, damages, expenses, and causes of action of whatever kind or nature, and other losses of any kind, whether known or unknown, foreseen or unforeseen, (collectively, “Damages”) as a result of me and/or my child or ward entering onto Joffrey premises, taking a class at a Joffrey location or via remote learning, and/or participating in any Joffrey event, including but not limited to those related to the above described personal injuries, death, disease or property losses, or any other loss, and including but not limited to claims based on the alleged negligence of any of the Joffrey Parties or any other person. I further promise not to sue or Joffrey or any of the Joffrey Parties, and agree to indemnify and hold them harmless from any and all Damages resulting from my and/or my child’s or ward’s entering onto Joffrey premises, taking a class at a Joffrey location or via remote learning, and/or participating in any Joffrey event. I understand that my agreement herein is on-going and continuous and shall not need to be renewed, but Joffrey may request my updated signature at any time.
I further agree and request for myself and/or my minor children that our relevant health information regarding personal health information, care and treatment be released for the limited purpose of contact tracing related to the novel coronavirus COVID-19 pandemic. In accordance with New York State Law and the Privacy Rule of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), I understand that: (1) The information disclosed shall be limited only to information relevant to the COVID-19 pandemic and for the purpose of contact tracing; (2) This authorization shall NOT include disclosure of information relating to alcohol and drug abuse, mental health treatment, or confidential HIV related information. If this information is disclosed, I understand that I have the right to request a list of people who may receive or use the disclosed information without authorization; if I experience discrimination because of the release or disclosure of such information, I may contact the New York State Division of Human Rights at (212) 480-2493 or the New York City Commission of Human Rights at (212) 306-7450, which are the agencies responsible for protecting my rights; (3) I have the right to revoke this authorization at any time by writing to the health care provider listed below. I understand that I may revoke this authorization except to the extent that action has already been taken based on this authorization; (4) I understand that signing this authorization is voluntary and health care treatment, payment of health care charges, enrollment in a health plan, or eligibility for health care benefits will not be conditioned upon my authorization of this disclosure; (5) Information disclosed under this authorization might be redisclosed by the recipient, and this redisclosure may no longer be protected by federal or state law; (6) THIS AUTHORIZATION DOES NOT AUTHORIZE DISCLOSURE OF HEALTH INFORMATION OR MEDICAL CARE WITH ANYONE OTHER THAN CONTACT TRACERS AND ONLY TO THE LIMITED EXTENT NEEDED FOR SUCH PURPOSE
I understand that should I be diagnosed with COVID-19 I must immediately withdraw from any in person class I am registered for and notify the Joffrey Ballet School if I have attended class in person in the prior 14 day period. Any unused class payments may be transferred to future class sessions and will require a negative test confirmation.
I have fully read and agree to all of the above, and I make this agreement and the representations herein in order to induce the Center for American Dance (d.b.a. Joffrey Ballet School), to allow me to audition to be a student for dance instruction.
In the event that the participant/student is a minor or is not of such capacity to be held legally responsible for executing this agreement, the undersigned parent and/or legal guardian signs this on behalf of the participant/student and individually. If, despite this release, the participant makes a claim against any of the Releases, the parent(s) and/or legal guardian(s) will reimburse the Releasee for any money which they have paid to the participant, or on his behalf, and hold them harmless.
