Zumba® Kids Jr. Liability and Photo Release Waiver

Parent/Guardian*

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Phone Number*
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Email*
example@example.com
Are you 18 years or older?*

YESNO
How'd you hear about this class?*

Release of Liability

Read Carefully

In exchange for participation in the activity of Zumba® Kids Jr. organized by Yes You Can Fitness, and/or use of the property, facilities, and services of Yes You Can Finess and Fountain Valley Recreation Center & Sports Park I agree for myself and for the members of my family to the following:

1. Agreement To Follow Directions. I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by Yes You Can Finess, or the employees, representatives, or agents of Yes You Can Finess.

2. Assumption of the Risks and Release. I recognize that there are certain inherent risks associated with the above-described activity and I assume full responsibility for personal injury to myself and (if applicable) my family members, and further release and discharge Yes You Can Finess for injury, loss, or damage arising out of my or my family's use of or presence upon the facilities of Yes You Can Finess, whether caused by the fault of myself, my family, Yes You Can Finess or other third parties.

3. Indemnification. I agree to indemnify and defend Yes You Can Finess against all claims, causes of action, damages, judgments, costs, or expenses, including attorney fees and other litigation costs, which may in any way arise from my or my family's use of or presence upon the facilities of Yes You Can Finess.

4. Fees. I agree to pay for all damages to the facilities of Yes You Can Finess caused by any negligent, reckless, or willful actions by me or my family. 5. Applicable Law. Any legal or equitable claim that may arise from participation in the above shall be resolved.

6. No Duress. I agree and acknowledge that I am under no pressure or duress to sign this agreement and that I have been given a reasonable opportunity to review it before signing. I further agree and acknowledge that I am free to have my own legal counsel review this agreement if I so desire. I further agree and acknowledge that Yes You Can Finess has offered to refund any fees I have paid to use its facilities if I choose not to sign this agreement.

7. Arm's Length Agreement. This agreement and each of its terms are the product of an arm's length negotiation between the Parties. In the event any ambiguity is found to exist in the interpretation of this agreement or any of its provisions, the Parties, and each of them, explicitly reject the application of any legal or equitable rule of interpretation which would lead to a construction either "for" or "against" a particular party based upon their status as the drafter of a specific term, language, or provision giving rise to such ambiguity.

8. Enforceability. The invalidity or unenforceability of any provision of this agreement, whether standing alone or as applied to a particular occurrence or circumstance, shall not affect the validity or enforceability of any other provision of this agreement or of any other applications of such provision, as the case may be. Such invalid or unenforceable provision shall be deemed not to be a part of this agreement.

I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS
Name (Child 1)*

First NameLast Name
Name (Child 2-if applicable)

First NameLast Name
Name (Child 3-if applicable)

First NameLast Name
Name (Child 4-if applicable)

First NameLast Name
Today's Date*

MonthDayYear
Date
Date of Class*

MonthDayYear
Date
Parent/Guardian*

First NameLast Name
PARENT/GUARDIAN SIGNATURE*

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Date*

MonthDayYear
Date
AGREE (Liability Waiver)*

YesNo

PHOTO RELEASE

For good and valuable consideration, the receipt of which is hereby acknowledged, I hereby grant Estelle Mathis (DBA Yes You Can Fitness) for and in consideration of Zumba Fitness, LLC (Zumba®) permission to use my likeness in a photograph in any and all of its publications, including but not limited to all of Estelle Mathis (DBA Yes You Can Fitness) for and in consideration of Zumba Fitness, LLC (Zumba®)'s printed and digital publications. I understand and agree that any photograph using my likeness will become property of Estelle Mathis (DBA Yes You Can Fitness) for and in consideration of Zumba Fitness, LLC (Zumba®) and will not be returned.

I acknowledge that since my participation with Estelle Mathis (DBA Yes You Can Fitness) for and in consideration of Zumba Fitness, LLC (Zumba®) is voluntary, I will receive no financial compensation.

I hereby irrevocably authorize Estelle Mathis (DBA Yes You Can Fitness) for and in consideration of Zumba Fitness, LLC (Zumba®) to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing Estelle Mathis (DBA Yes You Can Fitness) for and in consideration of Zumba Fitness, LLC (Zumba®)'s programs or for any other related, lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph.

I hereby hold harmless and release and forever discharge Estelle Mathis (DBA Yes You Can Fitness) for and in consideration of Zumba Fitness, LLC (Zumba®) 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.
Parent/Guardian*

First NameLast Name
Signature*

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Date*

MonthDayYear
Date
AGREE (Photo/Video Release)*

YesNo

Emergency Contact

In case of an emergency, please contact (additional person aside from primary parent/guardian):
Name*

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Phone Number*
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Should be Empty:

Emergency Contact