Agreement of Release & Waiver of Liability - Liturgy Pilates LLC
PLEASE INITIAL UNDER EACH STATEMENT.
Email address *
I will receive information and instruction while participating in the classes offered by Liturgy Pilates LLC. I recognize that classes will require physical exertion, which 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 this class or any other activity associated with pilates provided by Liturgy Pilates LLC. I acknowledge that I have either had a physical examination and have been given physician permission to participate, OR that I have decided to participate in activity and/or use of equipment without the approval of my physician AND do hereby assume all responsibility for my participation and utilization of equipment in my activities. *
I represent and warrant that I am physically fit and have no medical conditions that would prevent my full participation in the class. *
I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I may incur as a result of participating in the pilates sessions. *
I knowingly, voluntarily and expressly waive any claim that I may have against Liturgy Pilates LLC for any injury or death incurred by my voluntary participation in sessions with Liturgy Pilates LLC. *
Heirs, my legal representatives and I forever release and waive any liabilities against Liturgy Pilates LLC for any injury or death incurred by my voluntary participation in sessions with Liturgy Pilates LLC. *
I HAVE READ THE ABOVE RELEASE & WAIVER OF LIABILITY AND FULLY UNDERSTAND THEIR CONTENTS. I VOLUNTARILY AGREE TO THE ABOVE TERMS & CONDITIONS. I UNDERSTAND THAT ENTERING MY NAME BELOW CONSTITUTES AN ELECTRONIC SIGNATURE THAT HAS THE SAME LEGAL EFFECT & CAN BE ENFORCED THE SAME WAY AS A WRITTEN SIGNATURE. Please type your name and the date below. *
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service