VITAL INNOVATIVE PILATES LLC
WAIVER & LIABILITY RELEASE FORM
I, ____________________________________________, hereby agree to the following:
I understand and acknowledge that the training, classes, and other programs and events held by Vital Innovative Pilates LLC (“VIP”) may expose me to the inherent risks involved with Pilates and physical exercise generally, including accidents, physical injury, illness, or even death.
I acknowledge my responsibility to obtain a physical examination from a doctor before participating in any exercise activity and understand that any physical exercise or activity I undertake is done so voluntarily and entirely at my own risk. Further, any recommendation for changes in diet, exercise regime, or weight reduction are entirely my responsibility and that I should consult a physician prior to undertaking any such changes.
I agree to disclose in writing all my physical and/or medical conditions, limitations and sensitivities on Exhibit A hereto and to disclose any future changes to VIP in writing.
I agree to comply with all rules imposed by VIP regarding the use of the facilities and equipment and agree to conduct myself in a controlled and reasonable manner at all times, and to refrain from using any equipment in a manner inconsistent with its intended design and purpose.
In consideration of being permitted to participate in the training, classes, and other programs offered by VIP, I expressly agree and contract, on behalf of myself, my heirs, executors, administrators, successors and assigns, that VIP, its insurers, owners, officers, directors, employees, trainers, independent contractors and agents, shall not be liable for any damages arising from personal injuries (including death) sustained by me, as a result of the training, classes, and other programs offered by VIP, or from use of the equipment or facilities, regardless of whether such injuries result, in whole or in part, from the negligence of VIP. By the execution of this agreement, I accept and assume full responsibility for any and all injuries, damages (both economic and non-economic), and losses of any type, which may occur to me, and I hereby fully and forever release and discharge VIP, its insurers, owners, officers, directors, employees, trainers, independent contractors and agents, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising out the use of said training, classes other programs, equipment and facilities. I expressly agree to indemnify and hold VIP and its insurers, owners, officers, directors, employees, trainers, independent contractors and agents harmless against any and all claims, demands, damages, rights of action, or causes of action, of any person or entity, that may arise from injuries or damages sustained by me.
I understand that VIP, its insurers, owners, officers, directors, employees, trainers, independent contractors and agents shall not be responsible or liable for personal property lost or stolen in, on, or about the premises or for loss or damages to my automobile or the contents thereof.
I HAVE READ THE FOREGOING WAIVER AND RELEASE OF LIABILITY AND VOLUNTARILY EXECUTED THIS DOCUMENT WITH FULL KNOWLEDGE OF ITS CONTENT.
Date: __________________ Signature: _________________________
Name: _________________ Cell: ______________________________
If Participant is under the age of 18:
As legal guardian of ___________________________, I consent to the above terms and conditions.
__________________________________ Date: ________________________
Signature of parent or guardian