Cynsationally Fit Waiver
In exchange for participation in the activity fitness and dance classes organized by Cynthia Henri, I agree for myself the following:

1. AGREEMENT TO FOLLOW DIRECTIONS
I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by Cynthia Henri or the employees, representatives or agents of Cynthia Henri.

2. AGREE TO ALL DANCE CLASS SPACE POLICIES
I understand and agree with all Cynthia Henri’s and the dance class space she uses. Including, but not limited to, the workshops no refund policy, no show policy and late cancellation policy.

3. ASSUMPTION OF THE RISKS AND RELEASE
I recognize that there are certain inherent risks associated with the above described activity and I assume full responsibility for personal injury to myself and further release and discharge Cynthia Henri for injury, loss or damage arising out of my use of or presence upon the facilities used for the dance class whether caused by the fault of myself, Cynthia Henri or other third parties.

4. INDEMNIFICATION
(To compensate for damage or loss sustained, expense incurred, etc.)
I agree to indemnify and defend Cynthia Henri against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my use of or presence upon the facilities of the dance class.

5. FEES
I agree to pay for all damages to the facilities of the dance class space caused by negligent, reckless or willful actions by me.

6. APPLICABLE LAW
Any legal or equitable claim that may arise from participation in the above shall be resolved under Massachusetts law.

7. NO DURESS
I agree and acknowledge that I am under no pressure or duress to sign this agreement and that I have been given a reasonable opportunity to review it before signing. I further agree and acknowledge that Cynthia Henri has offered to refund any fees I have paid to her if I choose not to sign the agreement.

8. PHOTO RELEASE
I understand, and agreed, that if I am asked to share photography and/or videography, and I agree, that I am authorizing Cynthia Henri to edit, change, copy and make any use of all photographs/videos of me used for promotional materials. I hereby acknowledge that I will not be entitled to payment or any sort of charge for such action. I understand and agree that I have the right to refuse this request
Sign in to Google to save your progress. Learn more
Email *
Electronic Signature *
The electronic signatures below and their related fields are treated by Cynthia Henri like a physical handwritten signature on a paper form.
Date *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report