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Please use the form below to sign up for - Dance Class: Intro to Middle Eastern and Turkish Style

Wednesday, April 13, 2022 - 6:00pm-7:30pm - Jefferson Alumni Hall, Atrium

Ever wanted to learn some basic belly dancing moves? Come join your fellow Jefferson students in a fun and judgement free zone as we gather for this one hour intro class perfect for beginners.

Wear attire and footwear suitable for fitness/movement. All participants will be required to sign a waiver.

PLEASE NOTE:  This event is only open to current matriculated Jefferson students.  Student status will be verified.

Questions? Email the Office of Student Life and Engagement at StudentLife@jefferson.edu.

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* 1. STUDENT INFORMATION

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* 2. CAMPUS

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* 3. ACADEMIC AREA

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* 4. Physical Activity
LIABILITY RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE


I voluntarily choose to participate in the Dance Class: Intro to Middle Eastern and Turkish Style Belly Dancing (“the Activities”) held by the Office of Student Life and Engagement. I understand that the Activities may occur indoors or outdoors and may involve physical activity.

I understand that this is a legally binding Release made by me to Thomas Jefferson University, Philadelphia, PA, and all of its employees, agents and affiliates as further described below. I fully recognize that there are dangers and risks in the Activities, as well as in my participation in the Activities. The following is a description and examples of specific, significant, non-obvious dangers and/or risks associated with the Activities: cuts, sprains, abrasions, fractures, trauma, shock, exposure to COVID-19 or other transmissible disease, illness, animal bites or scratches, head injuries and/or death. These are only examples and I recognize that there are other risks and dangers not specifically mentioned above. I understand that Thomas Jefferson University does not require me to participate in any of the Activities, but I want to do so, despite the possible dangers and risks and despite this Release.

I therefore agree to assume and accept, on behalf of myself, my family, heirs, and personal representative(s), all of the risks and responsibilities in any way associated with the Activities. In consideration of and return for the services, facilities, and other assistance provided to me by Thomas Jefferson University, I release Thomas Jefferson University, its affiliates and each of their governing boards, employees, and agents (collectively referred to as “Releasees”), from any and all liability, claims and actions that may arise from injury or harm to me, from my death or from damage to my property, including my animal(s), in connection with any of the Activities. I understand that this Release covers liability, claims and actions caused entirely or in part by any acts or failures to act of Releasees, including but not limited to negligence, mistake, or failure to supervise.

I recognize that this Release means I am giving up, among other things, rights to sue Releasees, or any of them, for injuries, damages, losses or death I may incur. I also understand that this Release binds my heirs, executors, administrators, representatives and assigns, as well as me.

I understand and agree that Releasees do not have medical personnel available at the locations of the Activities. I understand and agree that Releasees are granted permission to authorize emergency medical treatment, if necessary, and that such action by Releasees shall be subject to the terms of this Agreement. I understand and agree that Releasees assume no responsibility for any injury, damage or costs which might arise out of or in connection with such authorized emergency medical treatment.

In signing this Release, I acknowledge and represent that I have fully informed myself of the content of the foregoing waiver of liability and hold harmless agreement by reading it before I sign it, that I understand its terms, that I understand that I sign this document as my own free act and deed, and that no representations, statements, or inducements, apart from the foregoing written statement, have been made to me. I further state that I am at least eighteen (18) years of age and fully competent to sign this Agreement; and that I execute this Release for full, adequate, and complete consideration, fully intending to be bound. I further state that there are no health-related issues which preclude or restrict my participation in the Activities, and that I have adequate health insurance necessary to provide for and pay any medical costs that may be attendant as a result of injury to me.

I have read this entire Release. I fully understand i

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