Wufoo
Colony Yoga Waiver of Liability Updated June 2020
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1. That I am participating in the Health & Fitness Classes, Programs or Workshops offered by MoonBeam Inc. dba Colony Yoga (including those at The Colony Hotel at 525 E. Atlantic Ave Delray Beach FL 33483) during which I will receive information and instruction about health and fitness. I recognize that fitness programs require physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
Check Yes
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Yes
2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in Health & Fitness Classes, Programs or Workshops. I represent and warrant that I am physically fit and I have no medical condition that would prevent my full participation in the Exercise Classes, Health Programs or Workshops.
Check Yes
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Yes
3. In consideration of being permitted to participate in Health & Fitness Classes, Programs or Workshops, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the program.
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Yes
4. In consideration of being permitted to participate in Health & Fitness Classes, Programs or Workshops, I knowingly, voluntarily and expressly waive any claim I may have against MoonBeam Inc. dba Colony Yoga, Kelly Brookbank, and The Colony Hotel, for injury or damages that I may sustain as a result of participating in the program.
Check Yes
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Yes
5. I understand that this class may be filmed and my image may be used over the internet or on a DVD related to MoonBeam Inc and/or Colony Yoga and the organization or its partners may contact me via email.
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Yes
6. Coronavirus/COVID-19 Assumption of Risk, Waiver of Liability and Indemnity Agreement
I understand that (a) novel coronavirus/COVID-19, has been declared a worldwide pandemic by the World Health Organization, (b) COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact and (c) as a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people. I also understand that MoonBeam Inc. dba Colony Yoga and The Colony Hotel have put in place preventative measures to reduce the spread of COVID-19, but that they cannot guarantee that I will not become infected with COVID-19 as a result of participation in yoga classes, workshops or events.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death.
On behalf of myself, my children, my personal representatives, heirs, and next of kin, I hereby knowingly, voluntarily, irrevocably and expressly waive, release, indemnify, covenant not to sue, discharge, and hold harmless MoonBeam Inc. dba Colony Yoga, The Colony Hotel, its employees, contractors, agents, teachers, representatives, members, officers, directors, students, successors and assignees, of and from any and all claims, liabilities, demands, actions, damages, costs or expenses of any kind arising out of or relating to me or my children contracting COVID-19 as a result of attending yoga classes, workshops, or events at The Colony Hotel.
I additionally agree that I will not attend any classes, workshops or events or use The Colony Hotel facility in any manner whatsoever if:
a. I have a fever, cold symptoms, cough, shortness of breath or any symptom that would lead me to suspect I have contracted COVID-19.
b. For 14 days post contracting COVID-19 or 14 days from travel to an area affected by COVID-19 or 14 days from exposure to someone who has traveled to/from an area affected by COVID-19.
I further agree that I will inform MoonBeam Inc. dba Colony Yoga immediately by email to kelly@moonbeamyoga.com if I am diagnosed or suspect I have contracted or have been exposed to COVID-19 and I have been at The Colony Hotel facility within 2 weeks of such event.
I agree to comply with the following in relationship to use of the studio
1. Maintain a distance of 6 ft from other students and teachers and hotel guests and employees.
2. Cover mouth and nose with a tissue or use the inside of their elbow when coughing or sneezing. Tissues should be thrown in the trash immediately after use and hands washed according to CDC guidelines.
3. Use of masks and facial covering as much as possible especially before and after class.
4. Bring own waters, mats, blankets, towels, bolsters, or blocks and bring in the least amount of items possible to the studio. Shoes should be kept at the entrance and all other items shall be kept on the person or near their mat.
5. Use the bathroom at your home or office before arriving to minimize use of bathrooms at the facility.
6. Wash hands upon arrival to the studio and prior to exiting the studio with antibacterial soap for at least 20 seconds. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol and cover all surfaces of your hands and rub them together until they feel dry.
By electronically signing this agreement, I attest that I am 18 years of age or older, of sound mind, under no constraint or undue influence and that no oral representations, statements or inducements have been made in relationship to this agreement. I have carefully read this assumption of risk, release and waiver of liability agreement before signing below, and I fully understand and agree to the contents, meaning and impact of this agreement. I further understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release. I am signing this agreement freely and voluntarily and recognize that my signature serves as complete and unconditional waiver and release of all liability to the greatest extent allowed by law.
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Yes
By Entering My Name Below I Hereby Agree To The Above
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