CUMULUS WAIVER AND RELEASE OF LIABILITY

Version: July 2022

In consideration of the risk of injury while participating in dance classes (whether joining online classes or in-person) (the “Activity”), with Cumulus Dance/Amanda Jo Liscouski (“Provider”), located at 408 East Market St #104A, Charlottesville, Virginia 22902 and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and agree to the following conditions:

RULES AND REQUIREMENTS: Provider or any representative acting on behalf of Provider may terminate my participation in classes for any reason and at their sole discretion.

CERTIFICATION OF FITNESS TO PARTICIPATE: I am physically fit and do not have any medical record or history that could be aggravated by my participation. If any questions arise, I have been cleared and will seek clearance from a medical provider before participating or continuing to participate in Provider’s activities.

INFORMED CONSENT: I understand that classes with Provider may be physically strenuous and I voluntarily participate in them with full knowledge that there is risk of personal injury, illness, permanent disability, property loss, or death. I have been informed of and understand the nature of the classes. I assume full responsibility for my participation in classes and the use of Cville Jazzercise / Balletschool at Charlottesville Center for the Arts / McGuffey Art Center and Studio 20 facilities.

ASSUMPTION OF RISK AND WAIVER OF LIABILITY: I release any agents, staff, contractors, officers, volunteers acting at Provider’s direction or their successors and assigns, from all liability, including arising from any injury that I may suffer, including physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity, including traveling to and from an event related to this Activity. I agree that Provider is no way responsible for the safekeeping of my personal belongings while I attend class.

I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING IN A PHYSICAL ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM THE NATURE OF THE ACTIVITY, MY OWN OR OTHERS’ NEGLIGENCE, OR THE CONDITION OF THE ACTIVITY LOCATION(S). NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN OR UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY, INCLUDING TRAVEL TO, FROM AND DURING THIS ACTIVITY.

INDEMNIFICATION: I agree that I will indemnify and hold harmless Provider and its representatives, employees, volunteers, agents, officers, successors and assigns, from any and all liability, including any and all claims arising from any financial, mental or physical injury that I may suffer or damage that I may cause to others’ persons or property, as a result of my participation. I agree that neither I, my heirs, assigns, nor legal representatives will sue or make any other claims of any kind whatsoever against Provider or its program participants, members, agents, volunteers, instructors, or owners, for any personal injury, illness, permanent disability, property damage/loss, or wrongful death, whether caused by negligence or otherwise. Such indemnification shall not apply in the event of gross negligence or willful action.

PERSONAL MEDICAL INSURANCE: I have my own personal medical insurance and understand and agree that I am responsible for the cost of any and all medical services that I may require as a result of participating in dance/movement classes. In the event of any medical emergency, I authorize and consent to treatment and hospital care that personnel deem necessary for my safety and protection.

PROMOTIONAL RIGHTS: I grant to Provider and its agents and employees the irrevocable and unrestricted right to reproduce the photographs and/or video images taken of me during my participation in dance/movement classes for the purpose of publication, promotion, illustration, advertising, or trade, in any manner or in any medium. I hereby release Provider and its legal representatives for all claims and liability relating to said images or video. Furthermore, I grant permission to use my statements that were given during an interview, with or without my name, for the purpose of advertising and publicity without restriction. I waive my right to any compensation.

CHOICE OF LAW: This Agreement shall be construed in accordance with the laws of the Commonwealth of Virginia. I hereby acknowledge that I have read, understand, and will abide by each of the terms and conditions of this Agreement. I understand that I may seek legal counsel of my own choosing to fully explain any terms of this Agreement to me before I sign.

I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS “WAIVER AND RELEASE” AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE Cumulus Dance/Amanda Jo Liscouski AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST THEM FOR PERSONAL INJURY OR PROPERTY DAMAGE.

In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.

This Agreement constitutes the full understanding of the parties with respect to the subject matter hereof and supersedes all prior understandings and writings relating thereto. No waiver, alteration or modification of any of the provisions hereof will be binding unless made in writing and signed by the parties by their respective officers thereunto duly authorized. The parties have participated equally in the formation of this Agreement; the language of this Agreement will not be presumptively construed against either party.