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Caroline Calouche & Co. & Charlotte Cirque and Dance Center Waiver
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Student Name: *
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Date: *
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I agree that Caroline Calouche & Co. its owners, officers, directors, employees, successors and agents shall not be liable for any harm my child may come to while on the premises, or for damage to their property. I hereby release them and each of them from any and all liability for such harm, (except for gross negligence or willful misconduct) even though that harm may result from their negligence. *
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I assume any and all risk of injury (serious or otherwise) for me or my child. I further agree that if someone else is harmed through my child’s actions and blames the gym/venue, its owners, or its employees, for his harm, I will indemnify, defend, and old harmless the gym/venue, its owners, or its employees. *
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I agree to release, hold harmless, and indemnify Caroline Calouche & Co. its owners and its employees from any and all harm. Further, I agree that if any lawsuit is filed against the Caroline Calouche & Co. its owners, or its employees, on account of my injuries, my child’s injuries or my child’s injuries to another on account of my child’s actions, I will defend, indemnify, and hold harmless Caroline Calouche & Co. its owners and its employees. *
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Further, Caroline Calouche & Co. shall not be liable for any harm I or my child may come to, or any property loss that I or my child may incur, anywhere while using techniques learned in the aerial dance gym/warehouse, even though that harm may result form their negligence. I hereby release them and each of them from any and all liability (except for gross negligence and / or willful misconduct) for such harm also. *
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I or my child have read the safety rules of Caroline Calouche & Co. and agree to abide by them. I or my child is in good health and has no physical or mental limitations that would preclude them from careful and reasonably safe use of the gym/venue. *
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In consideration of being permitted to participate in aerial dance activities including but not limited to Rope and Harness, Fabric and Trapeze (hereafter known as Aerial Dance Activities) at and/or under the auspices of Caroline Calouche & Co., I do acknowledge, appreciate and agree that: **The risk of injury resulting from Aerial Dance Activities is significant. The risk includes but is not limited to all manner of injury resulting from my falling during Aerial Dance Activities and hitting the floor, wall faces, people, rope, fabric, and fixtures – whether permanently or temporarily in place. This risk also includes, but is not limited to, rope/fabric abrasion, rope/fabric entanglement and burn, injuries resulting from falling and dropped items. *
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**I do knowingly and freely assume all such risks both known and unknown, and I do knowingly and freely assume all responsibility for my participation in dance and cirque activities at and/or under the auspices of Caroline Calouche & Co. /Charlotte Cirque & Dance Center *
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**I will comply with ALL rules both written and verbally stated to me by the Dance & Cirque Staff Caroline Calouche & Co. /Charlotte Cirque & Dance Center. *
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**I understand that Caroline Calouche & Co. /Charlotte Cirque & Dance Center reserve the right to refuse or terminate service to me or my child for any reason not discriminatory, at any time. *
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I recognize that this is a contract. I have read it carefully and I sign it of my own free will. SIGNATURE OF PARENT OR LEGAL GUARDIAN if aerialist is under 18 years of age: (MUST BE WITNESSED). *
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