Studio 4 the Willing® Participant Information and Waiver/Release Form
WAIVER & RELEASE FORM
Because physical exercise can be strenuous and subject to risk of serious injury, you are urged to obtain a physical examination from a doctor before participating in any exercise activity. You agree that by participating in physical exercise or training activities, you do so entirely at your own risk. You agree that you are voluntarily participating in these activities and use of these facilities and premises and assume all risks of injury, illness (including Covid-19), or death. We are also not responsible for any loss of your personal property.
You acknowledge that you have carefully read this “waiver and release” and fully understand that it is a release of liability. You expressly agree to release and discharge the trainer or instructor from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against the trainer or instructor for personal injury or property damage.
To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence.
If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions severed here from.
This Release includes the right of Studio 4 the Willing, Debbi Robertson to use images or screenshots for the purpose of publicizing classes.
I acknowledge this Waiver and Release is between myself and Studio 4 the Willing, Debbi Robertson for Virtual Online Classes of Balletone, Barre, DanceFit4, REFIT, REV+FLOW and any other optional formats as well as live, in-person classes that I may attend, in any format and conducted by any Instructor as a representative of Studio 4 the Willing.
By signing this release, I acknowledge that I understand its content and that this release cannot be modified orally.
FIRST and LAST NAMES
I acknowledge marking this box as indication of my signature:
ADDRESS (Street, City, State, Zip)
Phone number (optional)
HOW DID YOU LEARN OF OUR CLASSES?
WHICH FORM OF CLASSES INTERESTS YOU?
ANY PHYSICAL LIMITATIONS?
EMERGENCY CONTACT NAME AND NUMBER
ANY ADDITIONAL QUESTIONS, INFORMATION
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