Give Back. Get Down. Zumba Event Benefiting Immigration Services

Put the FUN in fundraiser – Dance to support Catholic Charities’ Immigration Services!

Join our Immigration Services team member and licensed Zumba instructor, Maria Palacios, for a Zumba class on Saturday, October 1st at 10:30 AM.

Maria will be joined by local Zumba Instructors Katy Pineda, John Layseca, Pablo Lopez, Jack Marquez, and Juli Quevedo.

Class will take place at 208 East Avenue in Norwalk, CT inside the gymnasium at St. Thomas the Apostle. The event will host local vendors and raffles.

Donations are welcome if you are not able to participate! Please contribue using the “additional donation” space on the form below.

Liability Waiver:

This agreement is by and between Maria Palacios (herein referred to as the licensed Zumba®️ Instructor) and ‘FULL NAME’ from top section of this form (herein referred to as the participant).

By signing this agreement electronically, you hereby agree to the following:
1. I am participating in a Zumba®️ Class offered by a licensed Zumba®️ Instructor during which I will receive a cardio-dance workout following the Zumba®️ formula. I recognize that Zumba®️ requires physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
2. I understand that it is my responsibility to consult a physician prior to and regarding my participation in this Zumba®️ Class. I represent and warrant that I am physically and mentally fit and I have no medical condition that would prevent my full participation in the Zumba®️ Class. Special circumstances or known illnesses are to be reported to the licensed Zumba®️ Instructor independently before the Zumba®️ Class.
3. In consideration of being permitted to participate in the Zumba®️ Class, I agree to assume full responsibility for any risks, injuries, or damages, known or unknown, which I might incur as a result of participating in the program.
4. In further consideration of being permitted to participate in the Zumba®️ Class, I knowingly, voluntarily, and expressly waive any claim I may have against the licensed Zumba®️ Instructor for damages, and injury, including death, that I may sustain as a result of participating in the Zumba®️ Class.
5. I, my heirs, or legal representative forever release, waive, discharge and covenant not to sue the licensed Zumba®️ Instructor for any injury or death caused by my voluntary participation in the Zumba®️ Class.

I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.

For more information contact:

Maria Palacios, [email protected]