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Art Academy

ART ACADEMY ACCIDENT WAIVER & RELEASE OF LIABILITY FORM

PLEASE READ THE FOLLOWING INFORMATION

Consideration: I acknowledge the personal benefits accruing to my child by reason of participation in ZACC camp and am aware of the activities which my child will be involved through said participation.

Assumption of Risk: I am aware of the risks associated with my child's participation in the above event and do hereby voluntarily assume full responsibility for any risk of loss, property damage or personal injury, including death, that may result from my child's participation in event activities. Addtionally, I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.

• I further acknowledge that Zootown Arts Community Center has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.

• I further acknowledge that Zootown Arts Community Center can not guarantee that I, or any of my family members visiting the ZACC, will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Zootown Arts Community Center staff, volunteers, and other students and their families.

• I voluntarily signed my child up for services provided by Zootown Arts Community Center and acknowledge that I am increasing mine and their risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my child attends camp.

I attest that my child(ren):

• Are not experiencing any symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.

• Have not traveled internationally within the last 14 days.

• Have not traveled to a highly impacted area within the United States of America in the last 14 days.

• Have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19*. (*To your knowledge.)

• Have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities.

• Are following all CDC recommended guidelines as much as possible and limiting exposure to the Coronavirus/COVID-19.

Release / Indemnification: I hereby, in consideration of such benefits and other good and valuable consideration received, consent to the above listed participation and release absolutely, forever discharge, hold harmless and covenant not to sue Zootown Arts Community Center, and camp location, its directors, employees, agents, volunteers, and affiliates from any and all present or future liability, claims, demands, actions or rights of action, whether asserted by me or a third party arising out of my child's participation in the event activities (the "Claims"). I agree to indemnify and hold harmless Zootown Arts Community Center and camp location for any such Claims brought by me or a third party from any costs associated with defending or litigating such claims, including but not limited to attorney fees, costs and legal expenses.

ACKNOWLEDGEMENT OF WAIVER

I represent and acknowledge that I have completely read and understand this document and all its terms and all matters referred to herein, and I signed voluntarily as my free act and deed, that I have had ample opportunity to obtain the advice of counsel and that, by signing this document, I understand that I am relinquishing legal rights and remedies that may have otherwise been available to me. I understand that this Waiver and Release shall be construed as broadly and inclusively as is permitted by applicable law and agree that if any portion of this document is held invalid, the remaining shall continue in full force and effect. To the extent the restriction on filing lawsuits is deemed unlawful, I agree to submit any Claims to a mediation organization for binding resolution.

SIGNATURE
Parent/Guardian Name
First Name
Last Name
Date of Acknowledgement
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CULTIVATING COMMUNITY THROUGH ACCESSIBLE ARTS EXPERIENCES FOR ALL

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