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Renter Liability Waiver & Media Release
First name
Last name
Email
Date of Birth
Phone
Address
I assume responsibility for the health and wellbeing for all individuals entering HML as part of my rental, and assume liability for my participants:
No
Yes
I acknowledge that gym equipment is not part of my rental:
No
Yes
If using heels, tap shoes, Irish step, flamenco, or other hard shoes, I will be responsible for checking screws/edges for any irregularities to avoid damaging the floor:
No
Yes
If sneakers, we will make sure all footwear is indoor use only (if someone forgets the expectation is that they dance without shoes):
No
Yes
Initials
Emergency Contact Name
Emergency Contact Relationship to You
Emergency Contact Phone
Emergency Contact Email Address
Media Release. (HML won't be filming during any private rehearsals, but would love to be tagged in your social content to happily share/crosspost.)
I declare that the info I’ve provided is accurate & complete
I hereby release Human Movement Lab/Kim Holman from any liability for accidental injury or illness which may incur as a result of my studio rental. I hereby assume all risks connected therewith for both myself and all of my participants, and consent to the terms and conditions of the HML Lab Rental Policies (detailed here and by emailed contract). I acknowlege that the Lab's liability insurance does not cover any accident, injury, illness, or other condition that occurs due to participation in a space rental.
I have read the HML Policies on the website:
read here
Your Signature
Clear
If signing for a minor, minor's name
Submit
Thanks for submitting!
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