top of page


By signing I understand and consent to the following:

• I have NOT been diagnosed with or have been in close contact with anyone infected

by COVID-19 in the past 2 weeks, nor have I shown any symptoms or come in close

contact with anyone exhibiting the symptoms aligned with COVID-19 in the past 2


• If I begin to show symptoms of Covid-19 within 2 weeks of participating in this event, I

will notify the instructors immediately.

• I have been informed of the CDC Guidelines for participating in a social, outdoor

activity such as this, and understand that it is in my best interest to follow such

guidelines. Should I choose not to do so, I take full responsibility and in any

consequences that result in my decisions.

• I will follow protocols (distancing, sanitizing) in an effort to keep myself, and the others

around me healthy and I understand it is my choice to wear a mask during this activity.

• I have been given medical clearance to participate in high impact aerobic exercise by

my physician if I have any conditions that limit my physical activity. If I have not been

given the appropriate clearance and chose to participate, the licensed Zumba®

instructors, mentioned above, is not responsible for any incident that occurs as a result.

• I understand that I may briefly appear in photographs and/or videos of this event and

that may be used in various forms of advertising on behalf of the instructors, with my

consent for their use.

• I understand that there will be a continuous movement for 60 minutes and it is my

responsibility to stay hydrated and safe during the duration of this event. If at any time I feel lightheaded, dizzy, or any other abnormal symptoms, I will remove myself from the activity and seek medical attention immediately.

• Licensed Zumba® instructor Jasmine Colon is NOT responsible for any accidents,

injuries, or illnesses that occur as a result of my participation in this group exercise

event. I, therefore, waive my right to sue the above-named persons and ZumbaⓇ

Fitness from any and all claims including negligence, resulting in any accidents, injuries,

or illnesses I may suffer from participation in this activity, and thus, relinquish all

involved organizers (Jasmine Colon and ZumbaⓇ Fitness) from ALL liability.

Please complete the following.

Thanks for submitting!

bottom of page