Teachers can use the following form for use in their studios:
1. PARTIES: “Studio”: (Name of Music Studio or Music Instructor)
“Parent”: (Name of Parent or Legal Guardian)
“Student”: (Name of Student)
AUTHORIZATION AND RELEASE FROM LIABILITY REGARDING IN-PERSON MUSIC INSTRUCTION
2. AUTHORITY: The Parent represents and warrants that he and/or she is the lawful guardian of the Student and has the legal authority to bind the Parent and the Student. The Parent executing this Authorization and Release affirms to Studio that the other parent of the Student has agreed to enter into this Authorization and Release and that its terms and conditions are binding upon both the Parent and the Student.
3. COVID ADVISORY: 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 agencies recommend social distancing and compliance with safety protocols to mitigate the risk of contracting the virus.
4. SAFETY PROTOCOLS: The Parent acknowledges and agrees that the Student has been instructed by the Parent to strictly comply with all safety protocols implemented by the Studio to reduce the risk of contracting or spreading the virus while the Student is present at the Studio and/or taking music instruction. Safety protocols include, but are not limited to, wearing a face mask or covering at all times, observing physical distancing, frequent handwashing and/or the use of hand sanitizer, and any other safety and health protocols the Studio may implement.
5. ASSUMPTION OF THE RISK: Despite the safety protocols and procedures implemented by the Studio to mitigate the transmission of COVID-19, the Parent understands and acknowledges that there are inherent risks that the Parent or the Student may become infected with COVID-19 due to the Student’s participation in music instruction at the Studio. These risks include, but are not limited to, the following: exposure to COVID-19, becoming infected with COVID-19, or becoming a symptomatic or asymptomatic carrier of the virus. It is possible that the Parent and/or Student are already asymptomatic carriers of the virus and that the Student may infect other students, employees and other individuals at the Studio as a result of his or her participation in music instruction at the Studio. The Parent understands that his, her or the Student’s possible exposure to COVID-19 may result in Parent or Student spreading the infection to other family members or other persons. The Parent recognizes that any person who receives a positive diagnosis of COVID-19, including the Student or other family member, may encounter extended quarantine/self-isolation, additional tests, medical care, hospitalization, other potential complications, and the risk of death. Parent hereby acknowledges and assumes the risk of the Parent or the Student becoming infected with COVID-19 as a result of Student’s participation in music instruction at the Studio.
6. RELEASE OF LIABILITY: The Parent, on behalf of the Student and the other parent of the Student, hereby releases, covenants not to sue, discharges, defends, indemnifies, and holds the Studio, its owners, employees, agents and representatives harmless from any and all claims, liabilities, actions, damages, costs or expenses of any kind arising out of or related to the Student’s or Parent’s exposure to COVID-19 resulting from the Student’s participation in music instruction at the Studio.
SIGNATURE OF PARENT: