Thank you for your interest in attending my livestream Zumba® and/or Zumba Gold® classes, brought to you via Zoom.  I look forward to dancing with you!

Please complete the release of liability form below.  By entering and submitting your name and email address on the next page, you agree to the waiver detailed below.  Once I have received your completed form, I will add you to my livestream email list and will keep you informed of scheduled classes, and instructions for joining a class.
__________________________________________________________________________________________

RELEASE OF LIABILITY:
I understand that Zumba Fitness®, Zumba Gold® and Zumba Toning® involve vigorous physical activity.  I certify that I am physically able to participate in this activity.  I recognize and fully accept that I am responsible for my own intensity level, and will modify my movements as needed.  I have been advised to get a physician’s approval to participate.

I accept any and all responsibility for ensuring that the area around me is clear and safe for dance movement, and that my shoes are safe and appropriate for the floor surface on which I am dancing.

I accept any and all responsibility and assume all risk of any injury or damage to my person that may arise, whether directly or indirectly, as a result of my participation in dance fitness classes offered by Shari Chaney.  I hereby release and discharge her from all claims, damages and liability whatsoever that may result from my injury or death, accidental or otherwise, during or arising from participation in this activity.