WAIVER AND RELEASE FROM LIABILITY, AND ASSUMPTION OF RISK
In consideration of my voluntary participation in activities at 36 Woodland Ave., San Rafael, CA, I the undersigned, hereby waive all claims and/or causes of action to the fullest extent permitted by law, against Marin Ballroom Dance Theater and all other companies using this address, including Allco Engineering, Inc., A.Packard Corporation, Jusvox, and Marin Ballroom Dance Theater, as well as against the officers, owners, employees, representatives and agents of the above referenced companies and against any teachers teaching in this space, all of which are collectively hereinafter referred to as 36 WOODLAND AVE. I agree not to sue, and I agree to release and hold 36 WOODLAND AVE. harmless from all liability in connection with my participation. “Participation” includes, but is not limited to, travel to and from the activity.
Knowing, understanding , and fully appreciating all of these consequences, I hereby expressly, voluntarily, and willingly assume all risks and dangers associated with my volunteer participation. Some of these risks and dangers may include bodily injury. 36 WOODLAND AVE is also not responsible for any illegal acts that occur on its premises by outside parties. I understand that this list is not exhaustive.
I have no physical or emotional conditions which prevent me from fully participating in any activity in this space.
I further agree to indemnify and hold harmless 36 WOODLAND AVE. and others listed for any and all claims arising as a result of my engaging in or receiving instruction in activities sponsored by 36 WOODLAND AVE. or any activities incidental thereto. Whereever, whenever, or however the same may occur.
I am voluntarily participating in an activity at 36 Woodland Ave. with knowledge of the danger involved and hereby agree to accept and all inherent risks of property damage, personal injury, or death.
I understand that this waiver is intended to be as broad and inclusive as permitted by the laws of The State of California, and agree that if any portion in held invalid, the remainder of the waiver will continue to be in full legal force and effect. I further agree that the venue for any legal proceedings shall be in California.
I affirm that I am of legal age and am freely signing this agreement.
I HAVE READ THIS WAIVER, RELEASE, AND ASSUMPTION OF RISK FORM IN ITS
ENTIRETY.
I, , AGREE.
(print name)
(signature) (date)
Name of teacher:
Suzie's Studio
36 WOODLAND AVENUE, SUITE D, SAN RAFAEL, CA 94901
PHONE (415) 453-6797 FAX (415) 453-7091