If so, we cannot allow you to participate until you have the proper clearance from your doctor. Notice: It is recommended that you seek your doctors advice before beginning any health/fitness program.

Regular exercise is associated with many health benefits, yet any change of activity may increase the risk of injury. Completion of this questionnaire is a first step when planning to increase the amount of physical activity in your life. Please read each question carefully and answer every question honestly.

If so, please talk to your doctor or physician BEFORE, you become more physically active. Tell your doctor your intent to exercise and to which questions you answered yes. If you honestly answered no to all questions you can be reasonably positive that you can safely increase your level of physical activity gradually. If your health changes so you didn’t answer yes to any of the above questions, seek guidance from a doctor. Please make sure you are 100% committed to completing the program as no refunds are given.

This is a legally binding release waiver, discharge and covenant not to sue, made voluntarily by me, the undersigned releaser, on my own behalf and on behalf of my heirs, executors, and Harmony Health and Fitness administrators and or the owners of 16100 Poplar Creek Rd. I hereby consent to voluntarily engage in an exercise conditioning class that might include, but is not limited to, the following activities: walking, jogging, running, sprinting, jumping, going up and down stairs, punching, squatting, balance work, calisthenics with medicine balls, exercise bands, agility, endurance, speed, stretching, abdominal and functional training equipment and work. The levels of exercise that I will perform will be at my own pace, based upon my cardio respiratory fitness, muscular strength and endurance. I understand that there are risks that may be associated with any exercise program. I hereby state that I will inform harmony health and fitness of any symptoms during my participation in the exercise class that occur such as fatigue, shortness of breath, chest discomfort. I take full responsibility for stopping an activity myself if it becomes painful or hazardous to my health. I will be given instructions on how to perform an exercise and will ask any questions of harmony health and fitness if I do not understand. Harmony health and fitness will provide leader ship to direct my activities, monitor my performance, and otherwise evaluate my effort. If I have high blood pressure, diabetes, heart condition, or if I am taking any prescribed medication that will affect my performance in an exercise class, I will inform harmony health and fitness prior to participating in the class. I acknowledge that any type of exercise involves a risk of injury. Harmony health and fitness and/or 16100 Poplar Creek Rd., Athens, AL 35611 shall not be liable for any injuries or damage to the undersigned, or of the property of the undersigned, or subject to any claim, demand, injury or damages whatsoever, including, without limitation, those damages resulting from acts of active or passive negligence on the part of the class participants for the releaser. As the undersigned releaser I recognize that this release means I am giving up, among other things, all legal representatives and signs. It is agreed that harmony health and fitness shall not be responsible or liable to the undersigned for articles lost or stolen in connection with harmony health and fitness.

I grant permission to Harmony Health and Fitness to use my image for use in Mediapublications including: Videos, Brochures, photographs, & Social Media content. I hereby waive any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the image. I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.