Waiver

Sixth Street School of Music (herein titled SSSOM) Liability Waiver: 


Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19 - The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state agencies recommend social distancing and have, in many locations, prohibited the congregations of groups of people. SSSOM has put in place preventative measures to reduce the spread of COVID-19; however, SSSOM cannot guarantee those who enter the premises will not become infected with COVID-19.

Attending in-person lessons could increase risk of contracting COVID-19 for all in attendance. By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending in-person lessons at SSSOM and that such exposure or infection may result in personal injury, illness, permanent disability and death. I understand that the risk of becoming exposed to or infected by COVID-19 at SSSOM may result from the actions, omissions, or negligence of myself and others, including, but not limited to, SSSOM teachers, volunteers, program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)'s attendance at SSSOM or participation in any activities associated with SSSOM.

On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless SSSOM, its teachers and owners, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of SSSOM, its teachers, owners, agents or representatives, whether a COVID-19 infection occurs before, during, or after participation in any program.

Electronic Signature 

The electronic signature below and their related fields are treated by 6th Street School of Music like a physical handwritten signature on an paper form.

By my signature, I acknowledge that I have read and agree to all the above terms on my own behalf and that of all listed minor children (under 18) of whom I am legal parent/guardian. I affirm that all the information below is correct.

Name (Parent/Guardian for Any Minor)

Date of Birth (Parent/Guardian DOB for Any Minor)

Address

City

State

ZIP Code

Email

Minor #1 Name

Minor #1 Date of Birth

Minor #2 Name

Minor #2 Date of Birth

Minor #3 Name

Minor #3 Date of Birth

Minor #4 Name

Minor #4 Date of Birth

Minor #5 Name

Minor #5 Date of Birth


 

 

 

 

 

 

 

 

 

 

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