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Waiver
Liability 
disclaimer & notices 

A signed waiver is required for each participant, valid for 12 months.

Any student under 18 years old must have a parent/guardian’s signature on the waiver. 

Student's birthday

Liability disclaimer & notices 

Please read carefully text below** and give consent

Today's date

**Please read carefully text below and give consent

I, individually (and/or as parent/guardian of the minor identified above) hereby acknowledge the following notices and grant to Virginie Personne doing business as Petits Pas the following release from liability to the fullest extent permitted by law and agree that all terms hereof shall apply to all future classes to Petits Pas:

 

A. I acknowledge and fully understand that I, or my child, will be engaging in physical activities that may involve some risk of injury. I acknowledge and I have been advised that is is my responsibility to consult with my or my child’s physician with respect to any past or present injury, illness, health problem or any other condition or medication that may affect me or my child’s participation. I assume the foregoing risks and accept full personal responsibility for any personal injuries sustained by me or my child which might incur as a result of participating in any program provided by Petits Pas. I hereby agree to release, hold harmless and discharge Virginie Personne, doing business as Petits Pas, its employees, instructors, staff and agents from any claim, cause of action, liabilities for damages, expenses or judgments, including attorneys’ fees and court costs for any occurrences arising from any personal injury to me or my child or other persons or property caused by my or my child’s participation in any Petits Pas class, performace, summer camp or other programs related activities.

 

B. In the event that any kind of injury or illness occurring to me or my child listed above while on Petits Pas premises, I hereby authorize and grant permissions to Virginie Personne, doing business as Petits Pas and its employees, instructors, staff and agents to seek medical assistance, including calling 911. I understand that I will be responsible for any cost related to this medical assistance or any medical assistance provided by my own health care provider and agree to assume all liability for any expenses incurred in such an emergency (transportation, hospitalization, x-rays, etc.).

 

C. I authorize and agree Petits Pas to take pictures during programs (class, workshops, rehearsals, shows, camps, birthday parties,...) and use the registered student’s image for advertising purposes.

 

D. I have read and understand all cancellation and refund policies listed on the Petits Pas Website.

 

E. I agree that I, and/or my child will not attend class if ill. Being mindful of other children and I have read your sick policy.

 

F. Petits Pas reserves the right to refuse service to any student, parent, or legal guardian for any reason, including, but not limited to not adhering to the rules set forth in these policies. Petits Pas also reserves the right to change a student’s class based on appropriate age and/or skill level.

 

G. Petits Pas is not responsible for lost or stolen items. It is the responsibility of the parents or adult student to be aware of all center activities, including dates studio is open or closed, observation days, rehearsals and show schedule, class changes.

 

H. Petits Pas is not responsible for any car tickets or car that is towed in any parking lot or street parking. Please be mindful of street sweeping.

 

I. Petits Pas Website should be checked regularly. The schedule is subject to change; Petits Pas reserves the right to combine or cancel classes and/or modify teachers.

 

J. Risk Acknowledgment by Parent/Legal Guardian, regarding COVID-19

The collective effort and sacrifice of San Francisco residents staying at home limited the spread of COVID-19. But community transmission of COVID-19 within San Francisco continues, including transmission by individuals who are infected and contagious, but have no symptoms. Infected persons are contagious 48 hours before developing symptoms (“pre-symptomatic”), and many are contagious without ever developing symptoms (“asymptomatic”). Pre-symptomatic and asymptomatic people are likely unaware that they have COVID-19. Sports, dance, and cardio/aerobic exercise are higher risk for COVID-19 transmission, and have been linked to numerous outbreaks. In other parts of the City and County of Department of Public Health San Francisco Health Officer Directive 7 U.S., youth sports have been a significant source of COVID-19 spread among youth. The risks are generally much higher indoors than outdoors for these activities. But these activities are higher risk for COVID-19 in any environment because people breathe much more air when exercising, and have close contact in many sports. During exercise, a person with COVID-19 breathes many more infectious droplets into the air. The infectious droplets in their breath travel further because they are breathing harder. People are also more likely to be infected during exercise because they are breathing more air. The availability of organized youth sports activities hosted by a school program, childcare program, or out of school time program, is an important step in the resumption of activities. But the decision by the Health Officer to allow organized youth sports activities that follow required safety rules, does not mean that attending and participating in organized youth sports activities is free of risk. Enrolling a child in organized youth sports could increase the risk of the child becoming infected with COVID-19. Moderate-contact and high-contact sports, which can require frequent, close contact between participants, increase the risk of COVID-19 transmission. While the majority of children that become infected do well, there is still much more to learn about coronavirus in children, including about the risks of Multisystem Inflammatory Syndrome in Children (MIS-C) and COVID- 19 associated myocarditis, which can result in sudden death during exercise. Each parent or guardian must determine for themselves if they are willing to take the risk of enrolling their child in organized youth sports, including whether they need to take additional precautions to protect the health of their child and others in the household. They should carefully review the SFDPH COVID-19 youth safety guidance at http://www.sfcdcp.org/CovidSchoolsChildcare. They should particularly consider the risks to household members who have a higher risk of severe COVID-19 illness, including older adults and other people with chronic conditions or compromised immune systems. Parents and guardians may want to discuss these risks and their concerns with their pediatrician or other health care provider. More information about COVID-19 and MIS-C, is available on the Centers for Disease Control and Prevention website at https://www.cdc.gov/coronavirus/2019-ncov/your-health/about-covid-19.html.

I understand the risks associated with enrolling my child in organized youth sports, and agree to assume the risks to my child and my household. I also agree to follow all safety requirements that the Host of the organized youth sports activity imposes as a condition of enrolling my child.

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