Zumbini Liability Waiver
I understand that Zumbini includes physical movements for myself and my child participant, as well as an opportunity for fun instrument play. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will listen to my body, discontinue the activity. If my child participant experiences any pain or discomfort, it is my responsibility to care for my child and discontinue activity. I assume full responsibility for any and all damages, which may incur through participation.
Zumbini may not be recommended and may not be safe under certain medical conditions. By signing, I affirm my health, as well as my child's, is in good condition for any of the physical activity required of this program. In addition, I will make the instructor aware of any medical conditions or physical limitations before class. There are always movement modifications that can be suggested as an alternative to the routine presented in classes.
If I am pregnant, become pregnant or I am post-natal or post-surgical, my signature verifies that I have my physician's approval to participate. I also affirm that I alone am responsible to decide whether to have myself and my child participate, and if so, it is at my own risk.
I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against the certified Zumbini Instructor Jenene Dulaney Burke.
By my signature below, I certify that I am physically able to practice Zumbini and do hereby agree that Jenene Dulaney Burke is not responsible or liable to me or my children for any injury, accident, damage to health or loss of personal property.
I do hereby release Jenene Dulaney Burke from any claim or cause of action which may have occurred as a result of any medical problem known or unknown which I have knowledge presently or in the future.
I verify no promises or guarantees, other than those written in this agreement or were made to me by Jenene Dulaney Burke.
I agree to follow the instructional guidelines presented by Jenene Dulaney Burke.
I have read and fully understand and agree to the above terms of this Liability Waiver Agreement. I am signing this agreement voluntarily and recognize that my signature/confirmation serves as complete and unconditional release of all liability to the greatest extent allowed by law in the state of Florida.
I hereby grant Jenene Dulaney Burke permission to use my likeness in a photograph, video, or other digital media (“photo”) in web- based publications and online social media (e.g. Instagram, Facebook, Twitter) without payment or other consideration. I hereby irrevocably authorize Jenene Dulaney Burke to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo. I hereby hold harmless, release, and forever discharge Jenene Dulaney Burke from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. I HAVE READ AND UNDERSTAND THE ABOVE PHOTO/VIDEO RELEASE. I AFFIRM THAT I AM AT LEAST 18 YEARS OF AGE, OR, IF I AM UNDER 18 YEARS OF AGE, I HAVE OBTAINED THE REQUIRED CONSENT OF MY PARENTS/GUARDIANS AS EVIDENCED BY THEIR SIGNATURES.