COVID-19 Waiver Form
Sign in to Google to save your progress. Learn more
Email *
COVID-19 RELEASE OF LIABILITY & PROCEDURES
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 can be contracted from a variety of sources, including asymptomatic or pre-symptomatic carriers who might not realize they have the virus. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have limited the number of group gatherings.
PROCEDURES FOR ATTENDING BONZAI STUDIO
I understand that to participate in classes at Bonzai Studio that I may be subject to the following to be allowed into the facility and to practice in the studio space, receive services, or purchase inventory items:
• There will be no more than 10 students in the studio at a time. We are opening with a first come first served policy so please come early enough to get your spot. If we find we are meeting our 10 person capacity and having to turn people away, we will create a pre-registration system.
• We will ask you to wait outside the door until the person in front of you has finished signing in at the front desk.
• Wear a mask and if you do not have one, we will have one for you. You will be required to wear a face-covering at all times in the studio.
• Maintain at minimum six (6) feet between yourself and others. The studio floor will be marked with dots 10 ft apart for mats/standing. Please place your mat on one of the dots to help maintain appropriate social distance from your neighbor during practice.
• Before entering the studio, please wash hands in the restroom, and when you enter use the hand sanitizer provided.
• Please do not come to the studio/class if you have a cough, are running a fever, or have been exposed to someone who has been diagnosed with COVID-19 or is experiencing COVID-19 symptoms.
• Bring your own equipment if you have it. If need be, sign out some of ours for long term borrow or purchase some of the new equipment we have available.
• Come fully dressed for class, there will be no place for changing at the studio.
• We won’t be allowing cubby usage. The benches by the front of the studio will be for sitting to remove shoes only, so please limit your baggage. When you arrive, place all your belongings next to your mat/workout space.
• We encourage conversations and connection because that is what Bonzai is all about, but please out of mutual respect make your way out the door after class and keep those conversations outside rather than in the studio.
• If you have experienced or tested positive for COVID-19 within 14 days of your last studio visit, please notify us.

ASSUMPTION OF RISK
I acknowledge that Bonzai Studio and its staff have put precautionary measures into place to minimize potential risk of exposure and spread of the virus, but that Bonzai Studio cannot guarantee that I will not become infected by the virus while utilizing their services. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19, and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury, illness, damage, loss, claim, liability, or expense, of any kind, that I may incur.

WAIVER OF LIABILITY
I hereby release, covenant not to sue, discharge, and hold harmless Bonzai Studio, its employees, and representatives, from all liabilities, claims, actions, damages, costs, or expenses of any kind arising out of or relating to COVID-19.
I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.
Printed Name *
Electronic Signature *
Today's Date *
MM
/
DD
/
YYYY
Time *
Time
:
Under the Age of 18?
You MUST have a Parent/Guardian fill out the below information.
Parent/Guardian Printed Name
Childs Printed Name
Parent/Guardian Electronic Signature
Today's Date
MM
/
DD
/
YYYY
Time
Time
:
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Caitlyn Allen LLC. Report Abuse