Registration

Please fill out the following form.

Waiver

To the best of my knowledge, I am in good physical condition and fully able to participate in this program. I am fully aware of the risks and hazards connected with my participation, and herby elect to voluntarily participate. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OR LOSS, PROPERTY DAMAGE, OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by me, or loss or damage to property owned by me, as a result of participation.I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN THIS ACTIVITY OR EVENT, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event holder and organizer of the activity, in which I may participate, and that it will govern my actions and responsibilities at said activity or event. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: I HEREBY WAIVE, RELEASE, AND DISCHARGE Alexandra Loupatatzi-Mallia of Aether Academy and all divisions thereof of any and all liability and responsibility for injuries, sickness, pandemics, accidents, natural disasters and/or acts of God incurred during participation in and/or instruction of camps, private lessons, or any activity I may participate.I understand that participating in such activities provided by Alexandra Loupatatzi-Mallia of Aether Academy and any associates may cause me or my child risk of concussion, minor or severe injury, in which case I am responsible to seek professional medical help at no cost or risk to Alexandra Loupatatzi-Mallia of Aether Academy. In order to stay informed and knowledgeable about the repercussions of a concussion and minor or severe injuries, I will take the conscious time and effort to inform myself about the prevention and preparedness of safety, understanding concussion and potential consequences of injuries, recognizing concussion symptoms and how to respond. In order for the injured person to return back to any of the provided activities after a suspected concussion, they will only be accepted after a medical professional has given a written medical consent to do so. Please, take your time to go through this free informative concussion training; Youth Sports Concussions | Florida Department of Health (floridahealth.gov)n case of a concussion, I acknowledge that I or my child will be I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, concussion or actions of any kind which may hereafter occur to me including my traveling to and from this program, THE FOLLOWING ENTITIES OR PERSONS: Alexandra Loupatatzi-Mallia of Aether Academy. I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this waiver, release and registration form from any and all liabilities or claims made as a result of participation in this activity or event, whether caused by the negligence of release or otherwise. The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL. PARENT / GUARDIAN WAIVER FOR MINORS(Only if student is under 18 years old)The undersigned parent and natural guardian does hereby represent that he/she is, in fact, acting in such capacity, has consent