Waiver and Release of Liability 

Please sign the waiver/release of liability and provide your contact information.

This form covers all classes, workshops, and activities offered by Hastings Tai Chi Study Group, its instructors, assistants, administrators, and guest teachers invited by the Hastings Tai Chi Study Group.   

In consideration for being allowed to participate in classes or activities offered by Hastings Tai Chi Study Group, I affirm and agree to the following:

I, the undersigned, acknowledge, appreciate, and agree that in this study there is risk of injury, including but not limited to risk of permanent injury, permanent paralysis or death. In addition, there is risk of illness including but not limited to communicable diseases such as MRSA, influenza, and COVID-19. 

I recognize that these activities may require physical exertion and direct physical contact with others. I understand the risks associated with these activities and agree to follow all instructions so I may safely participate in these activities. If I have any concerns about my ability to participate safely, I agree to inform my instructor of any physical limitations, disabilities, ailments, impairments, physical discomfort or injuries which may affect my ability to participate in said physical activity safely, and I take full responsibility for nondisclosure. 

I willingly agree to comply with the stated and customary terms and conditions for participation. This includes reporting any significant hazard I witness during my study at the Hastings Tai Chi Study Group.

I acknowledge and agree that photographs and video may be taken of me in my participation in and attendance at the Hastings Tai Chi Study Group, and freely agree to allow without restriction all uses of such photos and videos in the reporting and promotion of the Hastings Tai Chi Study Group and its location.

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and hold harmlessthe Hastings Tai Chi Study Group, its instructors and assistants, other participants, administrators, and owners and lessors of premises used to conduct the Tai Chi classes and related events (“Releasees”), with respect to any and all injury, illness, disability, death, or loss or damage to personal property, whether arising from the negligence of the Releasees or otherwise, to the fullest extent permitted by law.

I understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.

This Agreement is intended to be as broad and inclusive as is permitted by law. If any provision or any part of any provision of this Agreement is held to be invalid or legally unenforceable for any reason, the remainder of this Agreement will not be affected and will remain valid and fully enforceable.

Participant Name: ______________________    Participant Signature:______________________

DATE SIGNED:_______________

FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)

This is to certify that I, as parent/guardian with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of the activity and his/her responsibilities for adhering to the rules and regulations. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees—Hastings Tai Chi Study Group, and its instructors, assistants, administrators, and guest teachers invited by the Hastings Tai Chi Study Group from any and all liabilities as described in the entirety of this document and  incident to my minor child’s/ward’s involvement or participation in these activities as provided above, even if arising from their negligence, to the fullest extent permitted by law.

Parent/Guardian Name:________________________________________

Parent/Guardian Signature_____________________________________

DATE SIGNED:_____________________