This organization, Jazz Arts Project, AKA Jazz Arts Academy, along with its arts partner the Count Basie Center for the Arts AKA the Basie Academy, acknowledges the threat of the coronavirus (COVID-19) and, while we put in place preventative measures to reduce its spread, we in no way represent or warrant that COVID-19 infection will not occur through participation in these programs or in accessing the facilities in use. It is required that each parent or guardian, or registrant over 18 years of age, acknowledge and attest to each of these following declarations: On behalf of myself and/or my registering child, I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing and masking.

 

I also warrant that my child is not experiencing or exhibiting any COVID-19 related symptoms as outlined by the federal and state Center for Disease Control and Prevention (CDC) such as fever, dry cough, shortness of breath or difficulty breathing. I declare I have not traveled internationally or to a highly impacted COVID-19 area within the United State during the last (14) days.

 

I am not aware nor do I believe I have been recently exposed to a person or animal with a positive and confirmed case if COVID-19. I acknowledge that my child may be removed from any event or asked to leave by our faculty or other personnel should I exhibit any behavior in direct contrast to the guidelines and safety measures established. By signing below, I hereby release and agree to hold harmless Jazz Arts Project, AKA Jazz Arts Academy, its partners, directors, officers, and all sponsors, instructors, employees, organizers, volunteers, representatives and agents from any and all liability for the unintentional exposure or harm due to the Coronavirus (COVID-19). This release includes all causes of action, claims, demands, damages, costs, expenses, and compensation for damages or loss to myself and/or property that may be caused by any act, or failure to act, or that may otherwise arise in any way in connection with any services received. On behalf of myself or my registering child, I represent that I have full authority to sign on behalf of my family and that my signature binds each other person having authority to make decisions on behalf of my family.

 

I understand that I have the responsibility to immediately notify Jazz Arts Academy or the Basie Academy of Arts staff should my responses on this questionnaire change. If there are any changes or new symptoms come on prior to the start of class time, I will email zlorelli@gmail.com and rrepole@thebasie.org to inform Jazz Arts Academy and the Basie Education team. By indicating that "I accept and understand" in the Permission Agreement box below and My signature (electronic or written) at the end of this form is confirmation that I have read and fully understand and acknowledge the questions in this form and that answers are correct to the best of my ability.