Standard Waiver | mistyrasconsmith

Standard Client/Student Waiver

The Conekt LAB LLC. In Person & Online Services

First Name

Last Name

Phone

Name of Parent/ Guardian if Client/Student is under the age of 18 ("the undersigned") *Any additional preferred Contact #

I, the undersigned hereby releases, waives, discharges and covenants not to sue “The Conekt LAB LLC."the owner, "Misty RasconSmith", managers, instructor, Guest Instructors/Choreographers, hired- teachers and agents (hereinafter referred to as “releases”) from all claims, costs, liabilities, expenses or judgments, property damage, including attorneys’ fees and court costs to the undersigned, his/her personal representatives, assigns, heirs, and next of kin of any loss or damage, and any claim or demands, therefore on account of injury to the client/student/child in any way shape or form, whether caused by the negligence, including all foreseen and unforeseen accidents. I, the undersigned hereby agrees to indemnify and save and hold harmless the releases and each of them from any loss, liability, damage or cost they may incur due to the negligence, intentional act or other contributory act of the undersigned.

As indicated in our terms & conditions, your online appointment will be recorded through ZOOM INC., video conferencing for promotional purposes as well as any necessary record keeping for educational reference. *I further understand that selected video and pictures of Online and In Person Services will be used for promotional purposes only. The “releases” agree to only utilize images of clients/students/children appropriately in a positive light with integrity in connection with “The Conekt LAB LLC." and "Misty RasconSmith" when promoting Online and In Person Services. The undersigned further expressly agrees that the forgoing release, waiver and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the State of Texas and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

(Parent/ Guardian's initial if under 18)

Initials/ Signature

Date

I, the undersigned has read, understands, agrees and voluntarily signs the release and waiver of liability and indemnity agreement, and further agrees with the:

Terms & Conditions

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Standard Client/Student Waiver

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