Must be 16 & up* please type your name and date below to agree to the terms and conditions

THIS IS A RELEASE OF LIABILITY

READ IT CAREFULLY AND COMPLETELY BEFORE SIGNING.

By Attending and/or participating in an event, dance lessons, dance classes, or other such events, in the present or future, which are organized, and/or ran by Country Kick-Up at any location, you are hereby agreeing to the following:

You recognize that dancing is a form of physical exertion that may be strenuous, and may carry the possibility of physical injury, and you are fully aware of the risks and hazards that may be involved. You have also explained these risks to anyone accompanying you who may not be capable, for whatever reason, of understanding these risks by themselves.

You agree that due to the physical exertion of Dancing, that you and anyone under your responsibility are physically fit to the point of being able to perform the dances, moves, and interact with a partner in such a way as to prevent preventable injuries as much as may be possible.

You agree that you do not have any medical condition that would cause increased risk to yourself, or other attendees and/or dancers. Possible medical conditions could include, but are not limited to, cardiac events or tendencies that could make cardiac issues more possible, Pregnancies, transmittable and high profile diseases, spinal injuries or tendencies toward them, and/or other musculoskeletal injuries or impairments.

It is advised that any medical condition that may bring this to question should be brought to a medical doctor, at the discretion of the guest/attendee, and they should be consulted before Dancing is continued.

In exchange for your being permitted to attend and participate in any Event, class, program, or dance related to Country Kick-Up you acknowledge that you agree to assume full responsibility for any risks, injuries, or damages, known and unknown, which you, or parties which you are responsible for might incur as a result of attending and/or participating. By signing this form the participating party is stating; the venue providing space and the entity/nonprofit Country KickUp itself has zero responsibility for any actions by the private party.

You authorize Country Kick-Up to to capture/record, and use, any photo or video in which you, or any minors or other parties of which you are responsible for, may appear. Such may be used for promotional purposes, video distribution, future instruction, and other reasons. You also agree to waive any rights of compensation or ownership.

If this is particular point (5), is unacceptable, you agree to inform Country Kick-Up before such has been done and express your concerns. The final decision to record and capture video and/or photographs shall remain Country Kick-Up’s, as is stated in paragraph 5.

In exchange for being permitted to attend and/or participate in any events, classes, instructions, parties, programs, or dances, You knowingly, voluntarily, and expressly waive any claims which you may have against Country Kick-Up, their staff, personnel, employees, volunteers, independent contractors, and instructors for injury or damages that you, or any minors or other who are your responsibility, may sustain, or anything else as a result of attending and/or participating.

You acknowledge that Country Kick-Up, their staff, personnel, employees, volunteers, independent contractors, and instructors, cannot be held responsible for any loss or theft of your belongings and/or property, at all locations, and that you are solely responsible for them.

You have read all of the above release and waiver of liability and fully understand its contents. You voluntarily agree to the terms and conditions stated above.

THIS IS A RELEASE OF LIABILITY.

READ IT CAREFULLY AND COMPLETELY BEFORE SIGNING.

CORONAVIRUS/COVID-19 ACTIVITY PARTICIPATION ASSUMPTION OF RISK, RELEASE, WAIVER, AND DISCHARGE

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. It is believed that an asymptomatic individual can be infected with and transmit COVID-19 without their knowledge. Country KickUp (“CKU”) has put in place preventative measures recommended by the State of Colorado to reduce the spread of COVID-19, however, CKU cannot guarantee that you, your child(ren), your spouse, or anyone else will not become exposed to or infected with COVID-19 as a result of participating in a CKU program, event, or activity. Participation in a CKU program, event or activity could increase the risk of contracting COVID-19. NOW, THEREFORE, in consideration of being permitted to participate in programs, events and/or activities offered by CKU, I understand, acknowledge and agree to the following: I have independently evaluated and reviewed the risks of being exposed to or infected with COVID-19 and have determined to participate in CKU programs, events, and/or activities with full knowledge and acceptance of the risk. Fully understanding these risks, I, for myself, my child(ren), my spouse, my legal representatives, heirs, and assigns, hereby agree to assume full responsibility and liability for the risk of bodily injury, illness, permanent disability, and/or death which may result from exposure to or infection with COVID19 before, during, or after participating in a CKU program, event, or activity. I, for myself, my child(ren), my spouse, my legal representatives, heirs and assigns, hereby waive, release, and discharge CKU, its officials, employees, volunteers, attorneys, and agents from any and all liability to me, my child(ren), my spouse, my legal representatives, heirs, and assigns, for any and all losses or damages resulting from bodily injury, illness, permanent disability, and/or death, whether caused by negligence of CKU or its officials, employees, volunteers, attorneys, and agents or otherwise, which claims, losses, and demands arise during or result directly or indirectly from exposure to or infection with COVID-19 before, during, or after participating in a CKU program, event, or activity. I also acknowledge that in the event the State or local health department issues a mandatory “Stay at Home” order, or mandates the closure of certain programs and/or facilities, participant(s) will be entitled to a partial credit at the discretion of the District. By signing this statement, I agree I have shown no signs of COVID or Symptoms within the last 14 days.

*The signing of this document confirms that the signer's signature and all terms stated are valid for the present day event as well as every CKU event attended after this day and moving forward.

Refunds will NOT be issued.

(Auto-signed through check-in)

Print Name of Attendee