Participation Waiver
Students and Parents of Students <18 must agree to this waiver

Participant's Full Name *

Participant's Preferred Name and Pronouns

Date of Birth *

Legal Guardian's Name (if participant under 18)

Contact Email Address *

Physical Address *

Contact Phone Number *

Please list any medical conditions, active injuries,
and medications (or type "None") *

Name of Emergency Contact *

Emergency Contact Number *

I would like to participate in: *

Private Workshop

Open Training

Intro to Bar Aerials - Wednesday 1800-1900 Block B ($90)

Intro to Fabric Aerials - Saturday 1300-1400 Block B ($90)

Late Enrolment

One off class:

What would you like to enrol in? *

Participation Waiver
Please read carefully

Circotica Circus School Inc cares deeply about the well-being of its enrolled students and endeavours to provide a safe, fun, and supportive environment to learn circus arts.

1. I recognise that Circotica Circus School Inc provides circus training for the benefit of myself/my child and that participation in activities at Circotica Circus School Inc are a conscious choice. I understand that, to the best of their ability, the Instructors will provide a safe environment to train circus skills, but that accidents can still happen. *

2. While Circotica Circus School Inc holds health and safety paramount, I must assume and accept all responsibility for any personal injuries. I hereby waive and release Circotica Circus School Inc and its premises at 4/235 Waltham Road, Christchurch, from any liability for injuries or other harm and damages resulting from my/my child’s participation on the premises.

3. I am aware that circus training is fun but can also be very challenging, and that there are certain risks that cannot be eliminated, such as: bruises, friction burns, and overall discomfort. I recognise that there are many serious risks and waive all liability for sprains, fractures, paralysis, broken bones, psychological distress, & all other serious injuries. *

4. As a student at Circotica Circus School Inc I am responsible for myself and my fellow students and accept that the use of alcohol or drugs before/during classes is completely unacceptable, and that I am to report it to staff if there is any suspicious activity in this regard. *

5. Physical interaction and assistance; including spotting, guidance, partner exercises or skills will likely occur in classes. Participants who are not comfortable with such physical contact should inform their instructor, so that suitable adaptaions can be made. However, if adaptations cannot be made for any reason, the participant understands that they may not be able to participate in aspects of the class, for the safety of all involved.

At times participants may require physical assistance or spotting for safety reasons and it is acknowledged that this may not always be predicted nor avoidable. *

Consent for Participation

I have read and understood the Participation Waiver.

I agree to it on behalf of myself/my child and will not hold Circotica Circus School Inc liable for injuries that occur under their supervision. *

I consent to photos/videos being taken of myself/my child during their class. I understand and agree that these may be shared on social media and used for promotional and advertising purposes.

I will remember to:
Bring a drink bottle
Be kind to my classmates and myself
Wear appropriate clothing:
- Snug fitting such as gym tights and t-shirts are best
- Free from zippers and buttons
- Remove or tape over jewelery & piercings before class *

* = Input is required

Participation Waiver Students and Parents of Students <18 must agree to this waiver

Participation Waiver
Students and Parents of Students <18 must agree to this waiver