Full and Fit Family, LLC Fitness Registration
Yoga, Zumba, Dance Fitness. Full and Fit Family ,LLC
Address: 124 Court St. Middletown, CT. 06457
Contact us at (203)779-6374 Email us at FULLANDFITFAM@gmail.com
Email address *
Name *
Your answer
I _______________________________ (The Participant), hereby agree to the following: I am participating in yoga, ZUMBA and/or Dance Fitness (thereby referred to as wellness program), offered by Full and Fit Family, LLC, and during which I will receive information and instruction about the wellness. I recognize that wellness requires physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the wellness program I represent and warrant that I am physically fit and I have no medical condition that would prevent my full participation in the wellness. In consideration of being permitted to participate in the wellness program, 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. I hereby grant Instructor(s) permission to use my likeness in a photograph in any and all of its publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of Full and Fit Family, LLC and will not be returned. I hereby irrevocably authorize Full and Fit Family, LLC to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing Zumba® fitness programs or for any other lawful purpose involving Full and Fit Family, LLC. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph or video. I hereby hold harmless and release and forever discharge Instructor(s) from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. In further consideration of being permitted to participate at Full and Fit Family, LLC wellness program I knowingly, voluntarily and expressly waive any claim I may have against the certified instructor(s) for damages, and injury that I may sustain as a result of participating in the wellness activities (yoga, ZUMBA, Dance Fitness). I, my heirs or legal representatives forever release, waive, discharge and covenant not to sue the instructor(s) for any injury, including death, caused by my voluntary participation in the wellness activities. 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. This agreement remains in effect for as long as I participate in wellness fitness activities at Full and Fit Family, LLC. *
Required
By entering my name below I accept the terms put forth in the Full and Fit Family, LLC wellness fitness program. *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
I understand that I will have to pay $7 regular admission $5 student admission upon arrival *
Required
Submit
Never submit passwords through Google Forms.
This form was created inside of Full and Fit Family, LLC. Report Abuse