Release and Waiver of Responsibility Forms

These forms can be signed at class. Students can print and sign in advance if they choose.

Release and Waiver of Responsibility 

Agreement Not to Sue, Indemnification, and Hold Harmless Agreement

METALSMITHING AND JEWELRY MAKING ARE INHERENTLY DANGEROUS ACTIVITIES AND, AS SUCH, METALWERX, INC REQUIRES ALL PERSONS ATTENDING METALWERX, INC CLASSES, SEMINARS, OR WORKSHOPS (both in person and virtual) OR USING ANY METALWERX, INC EQUIPMENT OR FACILITIES TO SIGN THIS RELEASE AND WAIVER OF RESPONSIBILITY.

 

I, ______________________________________________ on behalf of myself, understand that metalsmithing and jewelry making are inherently dangerous activities and acknowledge that the following inherent risks are associated with such activities, including without limitation: (1) the use of and exposure to superheated gases and torches; (2) handling hot metals and solder; (3) exposure to sharp objects; (4) exposure to power tools, and (5) latent risks associated with exposure to potentially dangerous chemicals and other hazardous materials. I understand that my negligence or failure to act within my abilities may contribute to or result in an injury and that Metalwerx, Inc., its instructors, founders, officers and directors will not provide me with any medical treatment or pay for any medical or other treatment expenses should I become sick or injured.

Metalwerx, Inc ("Metalwerx") and its instructors, founders, officers, and directors hereby specifically disclaims any and all responsibility or liability for, and I, on behalf of myself and my heirs, next of kin, spouse, guardians, legal representative, executors, administrators, successors, and assigns hereby knowingly and intelligently release Metalwerx, Inc., and its instructors, founders, officers, and directors, from, any and all claims, whether known or unknown, which I may have relating to: (i) any and all damages to the student or any personal property of the student, including without limitation, indirect and consequential damages or injuries as a direct or indirect result of the inherent risks of metalsmithing and jewelry making; (ii) any liability relating to instruction, construction, design, use of any Metalwerx equipment or facilities, manufacture of any product, or any other activity undertaken in conjunction with classes, workshops or seminars offered by Metalwerx or as a result of the use or application of information given or contained in any class, workshop or seminar offered by Metalwerx or contained in any writing given to me by Metalwerx or (iii) any actions taken by me while on the Metalwerx premises with respect to construction, design, use of equipment or facilities or manufacture of any product.

I HEREBY REPRESENT AND WARRANT UNDER NO DURESS AND ON MY OWN FREE WILL THAT I UNDERSTAND THAT BY SIGNING THIS DOCUMENT, I MAY BE WAIVING CERTAIN LEGAL RIGHTS. I UNDERSTAND THAT I WILL BE RESPONSIBLE FOR ALL ACTIONS TAKEN AT THE METALWERX FACILITIES, INCLUDING WITHOUT LIMITATION, USE OF EQUIPMENT AND FACILITIES.  I UNDERSTAND THAT I WILL ALSO BE RESPONSIBLE FOR ACTIVITIES OUTSIDE OF METALWERX, THAT I MAY UNDERTAKE AS PART OF AN ON-LINE CLASS OR WORKSHOP SPONSORED BY METALWERX.   I UNDERSTAND THAT I AM SOLELY RESPONSIBLE FOR ANY AND ALL DAMAGES, WHETHER DIRECT OR CONSEQUENTIAL, FOR THE USE AND APPLICATION OF INFORMATION GIVEN AT ANY SEMINAR, WORKSHOP OR CLASS (BOTH IN-PERSON AND VIRTUAL) OR CONTAINED IN ANY WRITING DISTRIBUTED BY METALWERX OR AN INSTRUCTOR.

 

SIGNATURE: _______________________________________________

Signature of Parent or Legal Guardian if Student is a Minor

 

NAME:_____________________________________________________

Name of Parent / Guardian if Student is a Minor

 

DATE:_____________________________________________________

 

COVID-19 Health and Safety Requirements

Our Student Pledge and Commitment

I pledge to adhere to all policies as outlined by Metalwerx: COVID-19 Health and Safety Updates. I pledge that I will always wear a mask (except while eating) while inside the Metalwerx building. By signing this form, you certify that you are fully vaccinated for COVID-19 and 2-weeks have passed since your final inoculation. I attest that I:

  • Do not have a household member with COVID-19 symptoms.
  • Have not knowingly been exposed to COVID-19 in the past 10 days.
  • Do not have any of the following symptoms of COVID-19, according to the CDC:
    • Fever or chills
    • Cough
    • Shortness of breath or difficulty breathing
    • Fatigue
    • Muscle or body aches
    • Headache
    • New loss of taste or smell
    • Sore throat
    • Congestion or runny nose
    • Nausea or vomiting
    • Diarrhea

 

Covid-19: Waiver of Liability and Release Agreement

In consideration of being welcomed back to the premises at Metalwerx, Inc. (“MWX”), 50 Guinan Street, Waltham, Massachusetts (“the Premises”), and for the use of its tools and equipment,

 

I,  ____________________________________ acknowledge and agree to the following:

I understand the hazards of the novel coronavirus (“COVID-19”) and am familiar with the Centers for Disease Control and Prevention (“CDC”) guidelines regarding COVID-19. I acknowledge and understand that the circumstances regarding COVID-19 are changing from day to day and that, accordingly, the CDC guidelines are regularly modified and updated and I accept full responsibility for familiarizing myself with the most recent updates. Notwithstanding the risks associated with COVID-19, which I readily acknowledge, I hereby willingly choose to participate in metalworking classes and/or activities at the MWX studio. I have read, understood and now agree to follow the policies and procedures contained in the Metalwerx Reopening Plan.  A copy of the plan is attached to this agreement. I understand these policies are not only for my benefit but for the benefit of other students, studiomates, staff, and instructors. I acknowledge and fully assume the risk of illness or death related to COVID-19 arising from my being on the Premises and using the equipment and tools located on the Premises and hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE MWX, its officers, directors, agents, employees, instructors and assigns (the “RELEASEES”) from any liability related to COVID-19 which might occur as a result my being on the Premises. I shall indemnify, defend and hold harmless the RELEASEES from and against any and all claims, demands, suits, judgments, losses or expenses of any nature whatsoever (including, without limitation, attorneys’ fees, costs and disbursements, whether of in-house or outside counsel and whether or not an action is brought, on appeal or otherwise), arising from or out of, or relating to, directly or indirectly, the infection of COVID-19 or any other illness or injury. It is my express intent that this Waiver Agreement shall bind any of my heirs, assigns, representatives, and next of kin and shall be deemed as a RELEASE, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE the above-named RELEASEES. This Agreement and the provisions contained herein shall be construed, interpreted and controlled according to the laws of the Commonwealth of Massachusetts. I HEREBY KNOWINGLY AND VOLUNTARILY WAIVE ANY RIGHT TO A JURY TRIAL OF ANY DISPUTE ARISING IN CONNECTION WITH THIS AGREEMENT. I ACKNOWLEDGE THAT THIS WAIVER WAS EXPRESSLY NEGOTIATED AND IS A MATERIAL INDUCEMENT TO THE PERMISSION GRANTED BY RELEASEES FOR ME TO BE ON THE PREMISES AND FOR THE USE OF TOOLS AND EQUIPMENT THEREIN.

IN SIGNING THIS AGREEMENT, I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Waiver of Liability, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this Agreement for full, adequate and complete consideration fully intending to be bound by same.

IN WITNESS WHEREOF, I have signed this Waiver under seal on this _____________________________ day of _______________________, 2022.

 

SIGN BELOW TO ACCEPT THE PLEDGE AND WAIVER AGREEMENT

 

SIGNATURE: _______________________________________________

 

NAME:_____________________________________________________

 

 

Metalwerx Studio Safety Policies

 

Your Safety is Important to us. Every effort is made to keep these areas as safe as possible. However, the use of gas torches, caustic chemicals, and power or hand tools is inherently dangerous and caution should always be taken. The following is a list of requirements and safe operating procedures that must be followed when using Metalwerx facilities or your own tools and workspace.

Students are required to undergo the safety orientation training program prior to the use of any studio facilities. If you do not know how to use a tool or how to perform an operation, or feel uncomfortable, ask the technician, Instructor, or Teaching Assistant for assistance. Use common sense. If an unsafe condition exists - leave the area and notify the responsible person.

Metalwerx reserves the right and responsibility to refuse the use of the studio to any student who does not follow safe operating procedures, does not know how to use the equipment and refuses to accept instruction, or who is caught using the facilities without supervision. Any student found deliberately breaking the requirements set forth in this Policy will be barred from further use of the facility.

EQUIPMENT AND MACHINERY

Do not operate equipment you have not been trained to use. Ask an Instructor for help. Each student using Metalwerx facilities must be checked out by a Metalwerx staff member on the operation and safety of tools for everyone’s protection.  When in your own workspace, make sure that you understand how to use equipment safely, either by asking an instructor, or reading instructions for the equipment.

CLOTHES AND HAIR

Check your clothes and hair before you walk into the shop. In particular:

Tie up long hair or a long beard. No loose clothing. Ties, scarves, loose sleeves, etc, are prohibited when working. No Gloves, except safety gloves when working with hot objects (Kevlar) and chemicals (nitrile/latex). Avoid Flammable Attire. Fleece is prohibited. Cotton clothing and jeans are recommended. When working with chemicals, wear an apron to protect your clothing (and you!) Wear Appropriate Shoes. No open toed sandals. Wear shoes that give a sure footing. If you are working with heavy objects, steel toes are recommended. Remove Jewelry. It can get caught in spinning machinery

SMOKING, ALCOHOL, AND DRUGS ARE NOT ALLOWED

Any mind-altering or mind-impairing substances taken during or prior to working in the studio is hazardous for everyone. Metalwerx reserves the right to ask people suspected of being “under the influence” to stop working.

STUDENTS ARE RESPONSIBLE FOR HELPING TO MAINTAIN THE SAFETY AND CLEANLINESS OF THE STUDIO. THANK YOU FOR HELPING TO KEEP OUR STUDIO SAFE FOR EVERYONE.

LUNG PROTECTION

Dust Masks must be worn when working with abrasive wheels, polishing compounds, investment powders, and where appropriate. Respirator use when working with chemicals is strongly recommended. Soldering, Patination, and Torch Use must be done under the vent hood with the exhaust fan on. IN CASE OF FIRE, turn off the gas, inform a staff member, and see that 911 is called from a safe location. Fire Extinguishers are located near the soldering bench and exits at Metalwerx. Please ask a staff member for instructions on its use if necessary.  Make sure to have fire extinguishers installed in your own workspace.

EAR AND EYE PROTECTION

Safety Glasses should be worn at all times in the shop. Face Shields must be worn when using the polishing machine or heavy drill press. Ear Plugs or Ear Muffs are recommended during any activity that will produce loud noise over a prolonged period of time, such as hammering, running the belt sander, angle grinder, or heavy drill press.

 

 

 

 

 

 

 

 

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