Music Lessons

I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. Please sign below

This Student Release and Waiver of Liability Form (“Agreement”) is executed by the individual named below (“Participant” or “I” or “my”). The Participant desires to participate in programs and activities (“Program”) provided by or sponsored by The Cobb Foundation Northwest (“Foundation”), a Washington nonprofit organization. In consideration of being permitted by the Foundation to participate in the Program and in recognition of the Foundation’s reliance hereon, I agree to all the terms and conditions set for in this Agreement. 1. Assumption of Risk. I acknowledge that I am voluntarily participating in the Foundation Program and have considered foreseen and unforeseen risks that may arise as a result of my participation. I am also aware of the highly contagious nature of bacterial and viral diseases including the 2019 novel coronavirus disease COVID-19 and other infectious diseases (“Disease”), and the risk that I may be exposed to or contract such Disease by engaging in the Program, which may result in serious illness, personal injury, disability and/or death. I acknowledge that these risks may result from or be compounded by actions, omissions, or negligence of the Foundation employees or others. I understand that the Foundation has implemented reasonable measures to reduce the risk of injury from the Program and the spread of Disease, however, the Foundation cannot guarantee that I will not be injured or become infected with such Disease. Other risks associated with the Foundation Program, include, but are not limited to injury or resulting illness due to, but not limited to, playing musical instruments, interacting with other individuals, and physical activities such as walking, standing, running, bending, crouching, stooping, lifting, climbing, pulling and simply moving. NOTWITHSTANDING THESE RISKS, I ACKNOWLEDGE THAT I AM VOLUNTARILY PARTICIPATING IN THE PROGRAM WITH KNOWLEDGE OF THE DANGERS INVOLVED. I HEREBY AGREE TO ACCEPT AND ASSUME ALL RISKS OF INJURY, ILLNESS, DISABILITY, DEATH, AND/OR PROPERTY DAMAGE ARISING FROM MY ENGAGING IN THE PROGRAM, WHETHER CAUSED BY THE ORDINARY NEGLIGENCE OF THE FOUNDATION OR OTHERWISE. 2. Release and Waiver. I WAIVE, RELEASE AND DISCHARGE the Foundation and its directors, officers, employees, volunteers, representatives, and agents (collectively, the “Released Parties”) from any and all claims or demands of any kind and from all liability, penalties, costs, losses, damages, expenses, claims, or judgments (including attorney’s fees) resulting from injury, death or damage to any person or property of any kind, including, but not limited to, death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me. 3. Medical Health. I confirm that I am: (a) in good health, in proper physical condition, and do not have any medical or other conditions that would impair my ability to participate in the Program; and (b) not experiencing symptoms of any Disease (such as cough, shortness of breath, or fever), do not have a confirmed or suspected case of the Disease, and have not come in contact in the last 14 days with a person who has been confirmed to have or suspected of having the Disease. I will comply with all federal, state, and local laws, orders, rules, directives, and guidelines related to the Program and the Disease while participating in the Program, including, without limitation, requirements related to hand sanitation, social distancing, and use of face coverings and safety equipment. I will also follow all instructions, recommendations, and cautions of the Foundation at all times during the Program. If at any time I believe conditions to be unsafe, that I am no longer in proper physical condition to participate in the Program, or I begin experiencing symptoms of the Disease, I will immediately inform the Foundation and discontinue further participation in the Program. 4. Medical Treatment. I authorize the Foundation to seek emergency medical treatment on my behalf in case of injury, accident, or illness to me arising from my participation in the Program. I understand and agree that I am solely responsible for all costs related to such medical treatment, medical transportation, and/or evacuation. 5. Indemnification. I INDEMNIFY, HOLD HARMESSS AND PROMISE NOT TO SUE the Released Parties from any and all liabilities and claims made as a result of participation in this Program, whether caused by negligence or otherwise. 6. Photographic Release. I understand and agree that during the Program, I may be photographed and/or videotaped by the Foundation for internal and/or promotional use. I hereby grant and convey to the Foundation all right, title, and interest, including but not limited to, any royalties, proceeds, or other benefits, in any and all such photographs or recordings, and consent to the Foundation’s use of my name, image, likeness, and voice in perpetuity, in any medium or format, for any publicity without further compensation or permission. BY SIGNING, I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL RIGHTS. * Participant Signature

I am the parent or legal guardian of the Participant named above, I have the legal right to consent and, by signing below, I hereby do consent to the terms and conditions of this Student Release and Waiver Liability Form. Parent/Legal Guardian Signature