OlyDance Covid Waiver
Customer Risk & Vaccine Acknowledgement
For your safety and the safety of our community, please read and answer the below statements.  Each person should fill out their own form. You must have proof of full vaccination or immunity at each OlyDance event.
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Email *
Name (first and last) *
If you should contract COVID within 2 weeks of attendance at OlyDance, do you agree to inform us? *
You are fully vaccinated 2 weeks after the 2nd shot with Pfizer-BioNTech and Moderna, and 2 weeks after your shot with Johnson & Johnson's Janssen.
Please be prepared to show vaccination card along with a matching form of identification if requested the first time attending Tuesdays Swing and filling out this form.
    Are you fully  vaccinated against Covid-19?   *
 I hereby release, covenant not to sue, discharge, and hold harmless OlyDance LLC, its employees, agents, and representatives, from all liabilities, claims, actions, damages, costs, or expenses of any kind arising out of or relating to COVID-19.

I agree and acknowledge that I am fully aware that participation in this activity may involve risks and I accept all the risks of participating. I will progress at my own pace and I understand my physical limitations, so I am sufficiently self-aware to stop physical activity before I become ill or injured. In consideration of being permitted to participate in the dance classes, I knowingly, voluntarily, and expressly waive any claim I may have against OlyDance for injuries or damages that I may sustain as a result in participating in the dance classes. This form acknowledges that I shall not now, or at any time in the future, bring any legal action against OlyDance the instructor(s), and/or any other person who may teach at OlyDance; and that this waiver is binding on me, my heirs, my spouse, my children, my legal representatives, my successors, and my assigns.

I agree and acknowledge: (Please Type Full Name) *
Any thing you would like to tell us?
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