Performance Waiver and Release of Liability Form (COVID-19 guidelines addressed)
Integral Ballet School City of Merrick, NY
Waiver and Release of Liability
Please read carefully before signing.
1. I wish to participate in the performance I have registered and paid for with Integral Ballet School in
the city of Merrick, NY at Usdan Center for the Creative and Performing Arts, Inc. being held by
ABD Events, LLC.
2. My participation in this performance is voluntary. I acknowledge that participating in the performance
carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid
them. Such risks include: (1) minor injuries such as bruises and sprains; (2) major injuries such as joint or
back injuries, broken bones, and head injuries; and (3) catastrophic injuries including paralysis and
death. I, and my performance guests, assume any and all risks, both known and unknown, while
participating in the performance.
3. I acknowledge that 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. Integral Ballet School has enacted preventative measures to reduce the spread of COVID-19.
Integral Ballet School, however, cannot guarantee that participants in the performance will not become
infected with COVID-19. I acknowledge the contagious nature of COVID-19 and voluntarily assume the
risk I, or my fellow guests during the performance, may be exposed to or infected by COVID-19 by
participating in the performance.
4. To the best of my knowledge I have no physical or medical condition that would prevent me from
participating in the performance. I warrant that I, or my fellow guests during my performance, do not
have any symptoms of COVID-19, including, without limitation, fever, cough, shortness of breath or
difficulty breathing, chills, or muscle or body aches; or have a suspected or confirmed diagnosis of
5. In consideration of being allowed to participate in the performance, I understand and agree that
neither the Integral Ballet School, nor the City of Merrick, nor any person acting on behalf of Integral
Ballet School, nor the City of Merrick, may be held liable in any way for any event which occurs in
connection with this performance, which may result in harm, death, injury or other damage to me.
This waiver of liability does not waive liability for any injuries that I obtain as the result of willful, wanton
or intentional misconduct by Integral Ballet School, or the City of Merrick or any person acting on behalf
of Integral Ballet School.
6. I agree to comply with all rules related to the performance including policies related to social
distancing and personal hygiene to help prevent the transmission of COVID-19. If I observe any unusual
or significant hazard during my participation in the performance, I will stop participating and
immediately notify the nearest official.
7. I agree to immediately notify Integral Ballet School or the City of Merrick if I or a member of my
household, or one of my performance guests, receives a positive or presumptive diagnosis of COVID-19
within 14 days of my rental, and further agree to permit Integral Ballet School to notify those other
persons with whom I or my guests may have had contact during my Integral Ballet School performance,
at Integral Ballet’s discretion, of the positive or presumptive diagnosis. Notwithstanding anything herein,
Integral Ballet School shall not share my name or other personal identifying information with any third
party unless I give express written consent prior to such disclosure.
8. I agree to defend, indemnify and hold harmless Integral Ballet School, Usdan Center for the
Creative and Performing Arts, Inc. and ABD Events, LLC, and the City of Merrick for any expense
or liability the City may incur as a result of my conduct, actions or omissions while renting the facility.
9. It is my express intent that this Waiver and Release of Liability shall bind the members of my family, if
I am alive, and my heirs, assigns and personal representatives if I am deceased.
10. I grant permission for the use of any photographs, motion pictures, recording, or any other record of
my participation in this Activity for any legitimate purpose, without financial or other compensation or
11. If any court finds any portion of this Waiver and Release of Liability to be contrary to law, invalid, or
unenforceable, the remainder of the Waiver and Release of Liability will remain in full force and effect.
12. I have read the following documents, provided by Integral Ballet School: (1) Integral Ballet School
Rental Policies and Procedures; (2) Integral Ballet School Performance COVID-19 Guidelines and
Procedures. By signing below I agree that I and my guests will follow the policies laid out in those
13. I agree to limit the number of guests during my performance to the numbers stated in Integral
Ballet School Rental Policies and Procedures document, and acknowledge that my damage deposit
may be withheld if specified occupancy is exceeded. I agree to wear a mask or CDC recommended face
covering at all times while in the building. I agree to keep 6-foot distance from people who are not
members of my household at all times. I agree to engage in frequent hand washing.
14. I have read the above document (Integral Ballet School Performance Waiver and Release of Liability
Form) and understand the legal significance of signing this document.