Ms. Kat’s Music & Movement, LLC
Kathleen Brotherton, owner
Austin, TX 78727
(512) 553-2293

Ms. Kat’s Music & Movement Enrichment Program
Waiver of Liability, Release, Assumption of Risk & Indemnity Agreement.
This is a legally binding agreement.

I understand that by signing or electronically acknowledging this Waiver of Liability, I release and hold harmless Ms. Kat’s Music & Movement, LLC, and its owner, directors, employees, agents, instructors, volunteers, and all other persons or entities acting for them from any and all claims, demands, suits, cost and charges, in connection with or arising out of Ms. Kat’s Music & Movement classes (whether caused by the instructor, another student, aide, or guardian; or from the use of equipment, instruments, or classroom materials), including but not limited to the unlikely event of personal injury, bodily harm, or property damage occurring while the child/children named below is/are attending Music & Movement classes.

I understand that Ms. Kat’s Music & Movement, LLC does NOT provide childcare services, and that my child will be under the supervision of an authorized caregiver/aide for the duration of the class period. I understand that if my child is habitually and unreasonably disruptive during class sessions, he/she may be asked to discontinue future attendance so as to preserve the reasonable enjoyment of the other class attendees.

I have read and understand Ms. Kat’s Music & Movement’s Enrichment Class Policies, and understand that I will be provided a copy of this waiver upon written request.

Legal Name(s), Age(s) of Student(s)
Address: ____________________
Phone: _____________________
Email: _____________________

Printed Name of Parent/Legal Guardian

Signature of Parent / Legal Guardian