NSPA Liability Waiver

Release and Waiver of Liability Form

THIS IS A RELEASE AND WAIVER OF LIABILITY (the “Release”) in favor of Nrityarpana School of Performing
Arts (“NSPA”) a 501(c)(3) organization, and its directors, officers, employees, affiliates and agents, and the heirs, executors, personal representatives, successors and assigns of each of them (“NSPA Parties”).

By filling this form, you hereby certify that you are an adult, parent or legal guardian of the “participant” a minor child under the age of eighteen years, and you consent to their participation in NSPA programs which include, but are not limited to, dance classes and performances, educational workshops, community outreach, and volunteering.
In exchange for this participation, Participant Parent or Guardian does hereby freely, voluntarily and without duress, give this Release under the terms provided below. Please review the Terms carefully and let us know if you have any questions. You can reach anupa.mirle@gmail.com at any time.

First name

Last name

Contact number

Parent details (if applicable)

Parent name

Parent email

Parent contact number

Address

Name in lieu of signature

TERMS

PARTICIPANT AGREEMENT AND RELEASE FROM LIABILITY

1. Voluntary Participation

I acknowledge that I have voluntarily applied to receive the services indicated above. I further agree that my eligibility to receive said services may be terminated at any time by NSPA.

2. Release

In consideration of the opportunity afforded me to participate in the services noted above, I hereby agree that I, my successors, assignees, heirs, guardians and legal representatives, will not make any claim against NSPA, or any of its affiliated organizations (including local affiliates), or their officers, directors, or employees, or any suppliers of any materials or equipment that are used for fulfillment of the services, any of the NSPA volunteers or sponsors, or any other service recipients, for injury, death, or damage resulting from the act or omissions of any person or entity, however caused, arising from my participation in these services. I will further assume the complete risk of any activity done in violation of any rule or directive or instruction.

3. Indemnification

I am agreeing to release, indemnify the "releasees”, described in section 2 above, and hold them harmless from any and all liability, or costs, including but not limited to attorney fees, associated with or arising from my participation.

4. Media/Photographic Release

I do hereby grant and convey unto NSPA, and any of their affiliated companies, permission to use my name, statement(s) and my likeness in any and all of its publications or advertisements in print, television, online (including without limitation, its websites or pages on Facebook or other social media sites) and any other media, without compensation to me. This consent is irrevocable and is without payment. The materials will become the property of the NSPA Parties and will not be returned. I waive the right to inspect or approve anything in which my name, statement(s) or likeness appears, and I waive any right to royalties or other compensation arising or related to their use.

5. Medical Treatment

I do hereby release and forever discharge the NSPA Parties named in section 2 above from any claim whatsoever which arises on account of any first aid, treatment or service rendered in connection with my participation in the services.

6. Transportation

Acknowledge that this waiver, indemnification and release of liability agreement (“Agreement”) expressly include transportation to and from, or in connection with any activity or event of NSPA in any vehicle, including transportation to and from medical treatment.

7. Understanding of English

I acknowledge that if English is not my first language, I have sought out the assistance of someone competent to translate this form to me. My signature below shall be a declaration that I have so read and understand this Waiver, Indemnification, and Release of Liability Agreement.

8. COVID - 19

I agree and understand that Coronavirus, COVID-19 is an extremely contagious virus that spreads easily through person to person contact. Participating in a NSPA program could increase the risk of contracting COVID-19. NSPA in no way warrants that the COVID-19 infection will not occur through participation in NSPA programs. I hereby release NSPA, its respective directors, officers, agents, employees and volunteers from any claim arising from Participant’s contraction or transmission of COVID-19.

10. Knowing and Voluntary Execution:

I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Ohio and that this Release shall be governed by and interpreted in accordance with the laws of the State of Ohio in the United States of America. I agree that if any clause or provision of this Release is held invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release which shall continue to be enforceable.

I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE
THAT THIS IS A CONTRACT AND A RELEASE OF LIABILITY BETWEEN MYSELF AND NSPA’S PARTIES,
AND I E-SIGN IT OF MY OWN FREE WILL. BY SUBMITTING THIS AGREEMENT, I CERTIFY THAT I AM EIGHTEEN YEARS OF AGE OR OLDER.

By submitting this form, you accept all the terms provided above.

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