Thanks for submitting your liability waiver. Please show this message to your Cirka instructor or representative.

Cirka Performance Arts, LLC Release and Waiver of Liability and Indemnification

Cirka Liability Waiver

Cirka Performance Arts, LLC requires that every person participating in any of the activities or services provided by Cirka Performance Arts, LLC must read the information below in its entirety, and in acknowledgment of understanding of the information below, personally, or on behalf of their children and/or a minor for whom the person has guardianship of, sign this document before participating in any of the activities and services provided or sponsored by Cirka Performance Arts, LLC. In consideration for allowing me and/or my child and/or a minor for whom I am guardian, to participate in the activities and services provided or sponsored by Cirka Performance Arts, LLC, I hereby voluntarily and knowingly agree to these terms.


1. Attire.
ALL PERSONS PARTICIPATING IN ANY OF THE ACTIVITIES AND SERVICES PROVIDED OR SPONSORED BY CIRKA PERFORMANCE ARTS, LLC MUST WEAR APPROPRIATE CLOTHING AS APPROVED BY CIRKA PERFORMANCE ARTS. No jewelry, watches, zippers, or piercings (unless covered or stud earring) are permitted on the equipment.
 

2. Acknowledgment of Risks.

I acknowledge the activities and services Cirka Performance Arts, LLC provide include, but are not limited to: fitness training, fitness activities, performance training, and aerial training, including silks, lyra, hammock and bungee. I acknowledge and agree participating in Cirka Performance Arts, LLC activities and services involves known and unknown risks which could result in physical or emotional injury, including but not limited to: musculoskeletal injuries, broken bones, injuries caused by equipment that breaks or otherwise fails, drowning, brain damage, medical conditions resulting from physical activity, paralysis, temporary or permanent disability, and death. The risk associated with participating in Cirka Performance Arts, LLC activities and services also include property damage. I acknowledge I appreciate the character of the risks and dangers involved in participating in Cirka Performance Ats, LLC activities and services.


3. Appreciation and Assumption of Risks:
Having voluntarily and knowingly acknowledged the risks associated with participating in the Cirka Performance Arts, LLC activities and services, I now expressly and voluntarily accept and assume all such risks, including the risks that may be caused by the negligence or omissions of Cirka Performance Arts, LLC. I knowingly choose to voluntarily participate in the Cirka Performance Arts, LLC activities and services, and I elect to participate despite knowing and appreciating such risks and dangers. 
 

4. Release of Liability and Indemnification:

On behalf of myself and my child’s behalf and/or on behalf of a minor for whom I am guardian, my heirs, and my child’s heirs, my next of kin and my child’s next of kin, my successors in interest and my child’s successors in interests, my personal representatives and my child’s personal representatives, I hereby: 
 

A. Waive any claim or cause of action against, release from liability, and forever discharge, Cirka Performance Arts, LLC, its owners, officers, employees, and agents, for any liability for injuries to my person or property resulting from participation in Cirka Performance Arts, LLC activities or services. 
 

B. Agree to indemnify and hold harmless Cirka Performance Arts, LLC, its officers, owners, employees, and agents for any claims, causes of action, or liability for injuries to any other person or property resulting from my or my child’s and/or am in or for whom I am guardian’s participation in Cirka Performance Arts, LLC services or activities.  
 

C. I acknowledge that I have consulted with my physician and I/my child and/or a minor for which I am guardian of am/is in proper health and physical condition to participate in all Cirka Performance Arts, LLC activities and services. I certify that to the best of my knowledge, I/my child and/or a minor for whom I am guardian have no preexisting physical condition that may result in danger to myself, or others, through the participation of a physically intense program, or physical contact with others.
 

D. I/my child and/or a minor for whom I am guardian agree to follow any and all rules and instructions both written and verbal, as stated by the Cirka Performance Arts, LLC.

 

5. Severability.
I agree that if a court of competent jurisdiction finds any portion of this agreement void or unenforceable, the remaining portions will remain in full force and effect.

 

6. Authority to Photograph/Video
I acknowledge that Cirka Performance Arts may film, record, and/or photograph participants who receive services or watch performances from Cirka. I hereby give permission for Cirka to use my or my child's image, name and voice in all such films, recordings, and photographs taken by Cirka staff and contractors without receipt or distribution of compensation. 

 

 

If you are 18 years of age or older, please enter your personal information. If you are filling this out on behind of your child or guardian, please fill out their name and date of birth below.