1. I am aware of the existence of the risk on my physical appearance to the Dance Studio & the Building Premise and my participation to the activity of the Dance Studio that may cause injury or illness such as, but not limited to physical injury, Influenza, MRSA, or COVID-19 that may lead to paralysis or death.
2. I have not been, nor any member(s) of my household, diagnosed to be infected of COVID-19 virus within the last 30 days. I have not experienced symptoms that of fever, fatigue, difficulty in breathing, or dry cough or exhibiting any other symptoms relating to COVID-19 or any communicable disease.
3. I have not travelled internationally within the past 14 days.
4. With full knowledge of the risks involved, I hereby release, waive, discharge the Dance Studio and the building property, its board, officers, independent contractors, affiliates, employees, representatives, successors, and assigns from any and all liabilities, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, injury, or death, that may be sustained by me related to physical activities or COVID-19 while participating in any activity while in, on, or around the premises or while using the facilities that may lead to unintentional exposure or harm due to COVID-19 or physical activities.
5. I agree to indemnify, defend, and hold harmless the Dance Studio from and against any and all costs, expenses, damages, lawsuits, and/or liabilities or claims arising whether directly or indirectly from or related to any and all claims made by or against any of the released party due to injury, loss, or death from or related or unrelated to COVID-19.

*In consideration of my participation in the foregoing, I acknowledge and agree to all the above by submitting the form.