Informed Consent and Acknowledgement
In consideration for my attendance and participation in the class offered by Ben & Rotem Hornedo, I hereby waive all claims against Ben Hornedo, Rotem Hornedo, and any and all persons associated with the Alma do Jogo Capoeira School. I understand that my child is participating in a martial art that has body contact. I understand that this form of martial arts involves acrobatics, punches, kicks, elbows, knees, takedowns and such which could potentially cause serious injury. I understand the risk of participating in this form of arts training and hereby release Ben Hornedo, Rotem Hornedo and any and all persons associated with Balansa Center as well as all of its agents, employees and associates of and from any and all liability, claims, demands, actions, medical bills, and causes of action whatsoever arising out of or relating to any negligent or other act or omission, and/or any loss, damage, or injury, including death, that I may sustain or any damage of personal property. I also state that my child is in good physical condition and know of no reason why they can not participate in this form of training. I understand that in case of emergency, I hereby authorize any licensed medical personnel to perform any accepted medical assistance deemed necessary and I agree to bear the expense of any such treatment.
Additionally, I knowingly and willingly consent to being a part of classes during the COVID-19 pandemic. I understand COVID has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious. It is impossible to determine who has it and who does not due to the current limits of virus testing. I understand due to the inherent nature of movement classes that I have an elevated risk of contracting the virus simply by being on the premises. I confirm that neither I nor they are presenting any of the following symptoms of COVID 19 such as a temperature above 98.7, shortness of breath, loss of sense of taste or smell, dry cough, sore throat. I confirm that I have not been around anyone with these symptoms in the past 14 days. I do not live with anyone who is sick or quarantined. I understand that to prevent the spread of contagious viruses and to help protect each other I will have to follow the guidelines set forth. I understand social distancing between groups of at least 6 feet is required. I verify that I have not traveled outside the US in the past 14 days to countries that have been affected by COVID. I verify that I have not traveled domestically within the U.S by commercial airline, bus, or train within the past 14 days.