Activity Waiver & Release

Please fill out the form below, or if you prefer, you can print it out and bring it with you.

Activity Waiver & Release / Indemnification Agreement

While dancing is a fun and enjoyable recreational activity, I understand that there are inherent risks in dancing, stretching and related physical activity, including the risk of physical injury. I further understand that these risks may result from my child’s participation with Miss Maria’s School of Dance (“MMSD”), and I voluntarily assume the risks associated with such participation.

I am fully aware of these risks, and in consideration of my child’s participation in MMSD activities (“Activities”), I, on behalf of myself, my heirs, assigns, executor, administrator and representatives, hereby release and hold harmless MMSD and its employees, instructors and agents, from any and all liability, loss, damage, costs, claims and/or causes of action arising out of or relating to my child’s participation in the Activities.

I certify that (i) I am the parent or legal guardian of the child named below, (ii) there are no health-related reasons or problems which preclude my child’s participation in the Activities, and (iii) I have not been advised by a qualified medical professional that my child should not participate in the Activities.

I understand that MMSD is working hard to establish policies and practices designed to reduce the risk of exposure/contracting COVID-19, however, MMSD is not able to guarantee that students or others who visit MMSD will not be exposed to, or contract, COVID-19, whether in connection with the Activities or otherwise. Visiting or participating in Activities at MMSD is voluntary, and I understand I assume the risks associated with the same.

This agreement is governed by the laws of Massachusetts and shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. If any provision of this agreement is found to be unenforceable, the remaining terms shall be enforceable.

I agree to the Terms of this Activity Waiver & Release / Indemnification Agreement *

I HAVE READ THIS DOCUMENT IN ITS ENTIRETY, I FULLY UNDERSTAND ITS TERMS, AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Full Name of Participant *

Age *

Please list any allergies or concerns that may affect your child’s participation in the Activities and that will help us better understand how to make the dance class experience an enjoyable one for your child:

Face Mask Waiver *

I understand face masks are optional but subject to change based on local town or governmental mask mandates.

Photography Waiver *

By signing this waiver you agree Miss Maria’s may photograph, videotape, or otherwise digitally record and use images and/or sound recordings to use in any public media, including internet and social media.

Name of Parent or Legal Guardian *

Date *

Signature of Parent or Legal Guardian

Reset Signature

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