Kindermusik With Missy COVID-19 Pandemic Liability Waiver & Release
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COVID-19 Pandemic Liability Waiver and Release
As part of the consideration for the agreement of Kindermusik with Missy and Park Street UMC to provide education for my child, I hereby freely make the following representations and enter into this agreement:

1. This agreement will apply to Kindermusik with Missy and Park Street UMC, along with their respective directors, employees, and all other persons connected with our program.
2. This agreement is made on behalf of the individuals who execute the agreement below. In the cases that a parent or guardian executes this agreement, such parent or guardian hereby acknowledges and agrees that, for purposes of this agreement, “I” shall mean such parent or guardian, any other present or future parent or guardian of the child listed herein, the child, and the personal representatives, heirs, successors, and assigns, therefore, with the result that all such parties are bound by the terms of this agreement.
3. I understand and acknowledge that the city of Belmont has experienced community spread of the COVID-19 virus, which if contracted by myself or my child could be fatal. I understand that the COVID-19 outbreak is a global pandemic that Kindermusik with Missy or Park Street UMC cannot control alone. I further understand that Kindermusik with Missy & Park Street UMC is opening its doors to children in order to assist the community in coping with this crisis, despite the risk that opening will continue to spread the COVID-19 virus.
4. I understand that during my child’s participation at Kindermusik with Missy, my child may be exposed to the COVID-19 virus or the risk of such exposure, which cannot be completely eliminated. These hazards and risks include, but are not limited to, the dangers of serious illness and death.
5. I fully realize, accept, acknowledge and understand the risks involved with my child attending Kindermusik with Missy and voluntarily assume all of the risks associated with such attendance, whether such risks are known or unknown or listed herein.
6. I, for myself, my child, and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS KINDERMUSIK WITH MISSY AND PARK STREET UMC WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person, arising from any actions related to or arising out of my child’s participation in the Kindermusik with Missy program, whether arising out of the acts, omissions, or laxity of Kindermusik with Missy, to the fullest extent permitted by law.
7. I understand and agree that I will abide by the requirements of the city of Belmont, the county of Gaston, and the state of North Carolina, with respect to any ordinance, order, or other law regarding the COVID-19 pandemic, including but not limited to any stay at home order applicable to me and my family members.
8. I understand and agree that I will abide by the requirements of Kindermusik with Missy not to join our classes under circumstances prescribed by Kindermusik with Missy and Park Street UMC which directly adhere to the recommendations from the Centers for Disease Control and Prevention
9. I have received notice of what is considered to be a high-risk factor for the COVID-19 virus. I acknowledge that it is my responsibility to assess my own risk factors and make a decision regarding whether I can safely join a Kindermusik with Missy class.
10. I agree that the provisions of this agreement shall not be construed in favor of or against the party who drafted the agreement. In the event that any clause or provision of this agreement shall be held invalid, I agree that the remaining provisions shall remain in full force and effect.
11. By signing the Parent/Guardian line below, I represent and warrant that I am the parent or legal guardian of the child listed below.


I HAVE READ THE ATTACHED SAFETY POLICIES AND PROCEDURES AS WELL THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. *
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