LEGWORKS DANCE STUDIO
RELEASE FORM 2023 -2024
RELEASE OF LIABILITY: I HEREBY ACKNOWLEDGE AND UNDERSTAND THAT PARTICIPATING IN ON
PREMISE CLASSES AT 1040 Montauk highway, Shirley MAY REQUIRE A DEGREE OF PHYSICAL FITNESS,
AGILITY, STAMINA, STRENGTH, AND IT MAY INVOLVE STRENUOUS EXERCISE. I AGREE TO ASSUME
RESPONSIBILITY FOR ANY RISKS, INJURIES, OR DAMAGES, WHICH MAY INCUR AS A RESULT OF
PARTICIPATING IN ANY CLASS OFFERED BY LEGWORKS DANCE STUDIO. I HEREBY RELEASE AND
AGREE TO HOLD HARMLESS LEGWORKS DANCE STUDIO, ITS OWNERS, OPERATORS, EMPLOYEES, AND
INSTRUCTORS FROM ANY AND ALL LIABILITY WHATSOEVER FOR ANY AND ALL DAMAGES, LOSSES OR
INJURIES, INCLUDING DEATH, I MAY SUSTAIN TO MY PERSON OR PROPERTY OR BOTH, INCLUDING
BUT NOT LIMITED TO ANY CLAIMS, DEMANDS, ACTIONS, CAUSES OF ACTION, EXPENSES, AND
COSTS, INCLUDING ATTORNEY FEES, WHICH ARISE OUT OF, RESULTS FROM OR IN CONNECTION IN
ANY MANNER WITH THE PARTICIPATION IN CLASSES TAKEN AT LEGWORKS DANCE STUDIO.
MEDICAL EMERGENCIES: AS THE LEGAL PARENT OR GUARDIAN, I GIVE PERMISSION TO LEGWORKS
DANCE STUDIO, ITS OWNERS, AND OPERATORS TO SEEK MEDICAL TREATMENT FOR THE
PARTICIPANT(S) IN THE EVENT THEY ARE NOT ABLE TO REACH A PARENT OR GUARDIAN. I HEREBY
DECLARE ANY PHYSICAL/MENTAL PROBLEMS, RESTRICTIONS, OR CONDITIONS AND/OR DECLARE
THE PARTICIPANT(S) TO BE IN GOOD PHYSICAL AND MENTAL HEALTH.
PHOTO/MEDIA RELEASE: I GIVE PERMISSION FOR LEGWORKS DANCE STUDIO TO TAKE PHOTOS OR
VIDEOS OF ME OR MY CHILD(REN) WHILE PARTICIPATING IN LEGWORKS DANCE STUDIO ACTIVITIES.
MASKS: ARE OPTIONAL.
COVID RELEASE: AS I OR MY CHILD ARE ENROLLING TO PARTICIPATE IN ON PREMISE CLASSES AT LEGWORKS DANCE STUDIO AS OF SEPTEMBER 19TH 2022, BY SIGNING THIS AGREEMENT, I ACKNOWLEDGE THE CONTAGIOUS NATURE OF COVID-19 AND VOLUNTARILY ASSUME THE RISK THAT MY CHILD(REN) AND I MAY BE EXPOSED TO OR INFECTED BY COVID-19 BY ATTENDING IN-STUDIO CLASSES AT LEGWORKS DANCE STUDIO AND THAT SUCH EXPOSURE MAY LEAD TO ANY OR ALL COVID-19 RELATED SYMPTOMS, EFFECTS, OR OUTCOMES.
I HEREBY RELEASE, DISCHARGE, HOLD HARMLESS AND COVENANT NOT TO SUE LEGWORKS DANCE STUDIO FOR ANY INJURY TO MY CHILD(REN) OR MYSELF (INCLUDING, BUT NOT LIMITED TO, PERSONAL INJURY, DISABILITY, AND DEATH) ILLNESS, DAMAGE, LOSS, CLAIM, LIABILITY, OR EXPENSE, OF ANY KIND, THAT I OR MY CHILD(REN) MAY EXPERIENCE OR INCUR IN CONNECTION WITH MY CHILD(REN)’S ATTENDANCE AT LEGWORKS DANCE STUDIO OR PARTICIPATION IN ANY OF THEIR ACTIVITIES.
On my behalf, and the behalf of my child(ren) I hereby release, covenant not to sue, discharge, and hold
harmless LEGWORKS DANCE STUDIO, its employees, agents, representatives, of and from the claims, including all liabilities, claims, actions, damages, costs, or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on actions, omissions, or negligence of LEGWORKS DANCE STUDIO, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any LEGWORKS DANCE STUDIO programs.
