Covid-19 Survey

We are looking forward to having you come to our studio. To provide a healthy work environment for all please answer the following questions below.

  • Covid-19 Questions

  • Terms & Certification

  • COVID 19 & Release of Liability & Assumption of Risk - Communicable Diseases and Viral Infections

    You have been informed that providing services exposes both the member and the show providers to the possibility of spreading bacteria, viruses, infections and diseases. All members should be aware that studios uses appropriate sterilization and personal protective equipment to minimize the possibility of spreading any bacteria or viruses, however, no guarantees can be given that you are completely safe. Many communicable diseases are easily spread when humans are in close proximity. Therefore, you should be aware that by attending an event, it is a possible that you could become ill.

    AGREEMENT: You have been informed of the risks associated with attending an event. You understand that if you proceed with this treatment, you must assume all risks associated and understand that you could be exposed to bacteria, viruses, communicable diseases and life-threatening illnesses.

    ASSUMPTION OF RISK: Having been adequately informed of the risks associated with performing treatment, you freely agree to assume all risks (physical, financial or social) associated with your care, whether they currently are known or unknown. You are aware that you could have serious medical complications as a result of your dental care and you acknowledge that you could become seriously ill or even die as a result of this dental treatment. Therefore, you are prepared to assume all risks of this treatment.

    RELEASE OF LIABILITY: Having been fully informed of the risks of care and the risks associated with bacterial and viral transmission, you hereby, release the Studios, MediaOne and their staff of any and all liability associated with your care and agree to hold all parties harmless for any consequences with your decision.

    WHEREFORE: I attest that I am fluent in English and that I have read this document. I have been adequately informed of the risks and ramifications of bacterial and viral contamination during treatment and having been given the opportunity to ask questions, and with all my questions answered to my satisfaction, I give my informed consent for treatment. I, hereby, agree to assume all risks of treatment and I agree to be responsible for any additional costs associated with this decision. Therefore, I release all MediaOne Studios staff from any and all liability associated with my care and treatment and I personally assume all risks associated with my care, including, but not limited to: respiratory infection, pneumonia, viral infection, pulmonary edema, SARS-CoV-2 (Covid-19), coronary artery disease, heart attack, stroke, cancer, atrial fibrillation, kidney failure and increased mortality.

    PLEASE DO NOT ELECTRONICALLY SIGN YOUR DOCUMENT WITHOUT READING IT CAREFULLY. IT IS VITAL THAT YOU UNDERSTAND THE CONTENTS OF THIS FORM AND AGREE TO ACCEPT THE RISKS DESCRIBED HEREIN. YOU SHOULD KNOW THAT SIGNING THIS DOCUMENT COULD AFFECT YOUR LEGAL RIGHTS.

    Limitation of Liability

    We do not accept responsibility that the website, its servers, or email sent from the website are free of viruses or other harmful components. We will not be liable for any damages of any kind arising from the use of the website, including, but not limited to direct, indirect, incidental, punitive or consequential damages. Certain laws do not allow limitations as contained in this clause. If these laws apply, some or all of the above limitations may not apply to you and you might have additional rights.

    Applicable Law

    By visiting the website, you agree that the laws of the State of California, without regard to principles of conflict of laws, will govern these Terms of Use and any dispute of any sort that might arise between you and us relating to the use of this website. Any dispute relating in any way to your visit to or use of the website shall be subject to the exclusive jurisdiction of the state or federal courts located in Alameda County, California, and you consent to exclusive jurisdiction and venue in such court.

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