Liability and Waiver Release Form PUR MOVEMENT ACTIVE LIFE STUDIO INC.
1. I, _____________________________________,
hereby agree to the following: I am participating in dance, fitness, and/or Power Plate® Training classes at PUR MOVEMENT, and I recognize that dance, fitness and training classes require physical exertion which may be strenuous and may cause physical injury.
2. I fully understand that I may injure myself as a result of my participation in dance, fitness and training classes and forever waive release and discharge PUR MOVEMENT, its instructors, trainers, and members from any liability now or in the future, including but not limited to, muscle or ligament tears, strains sprains, pulls, broken bones, dislocations, joint problems, shin splints, heat exhaustion, knee, back, hip or foot injuries as well as potential for heart attack, paralysis or death; however caused, occurring during or after my participation in this exercise class and/or private sessions.
3. I understand that it is my responsibility to consult a physician prior to and regarding my participation in any class or session. I represent that I am physically fit and have no medical condition which would prevent my full participation. I fully understand that I am forever giving up, in advance, any right to sue or make claim against the parties I am releasing, if I suffer any injuries or any damages, even though I do not know what or how extensive any of those injuries or damages might be. I have read, and I am voluntarily assuming the risk of any injuries or damages.
I acknowledge that I must pay before participating in any services, no exceptions. I have read, understood, and comply with the PUR Policies, Cancelation and Terms of Agreement on www.purmovement.com/policy
4. I hereby give PUR MOVEMENT and its personnel permission to use my photo/video for promotional purposes as they see fit. I understand that I will not be compensated for allowing PUR Movement to use my name and likeness. I understand PUR Movement has the right to refuse service at any time, this includes initial session or class. Participation in one class and sign up of contract term does not preclude PUR Movement from subsequent refusal. PUR Movement has the right to refuse service at any time to any one for any reason.
In signing this release, I acknowledge and represent that I read the foregoing Liability and Waiver Release Form, fully understand the terms and sign it voluntarily as my own free act and deed and am not under any physical or emotional duress to sign. I am at least eighteen (19) years of age and fully competent. In case of emergency, I agree to allow the above parties to call for emergency medical assistance and I am aware that I am financially responsible to those medical services. If I am under (19), my parent/guardian is agreeing to all of the above. (Parent/Guardian must be present for first service)