New Student Form / Liability Waiver

1

Name* This field is required.

First Name

Last Name

2

Email

example@example.com

3

Phone Number* This field is required.

Please enter a valid phone number.

4

Do you have any health challenges we should know about?.

5

All purchases are non-refundable and non-transferable. Purchases can only be used during agreed-upon validity periods.* This field is required..

AcceptDecline

6

Private sessions are one-on-one. Group session size maximum will be determined by the facilitator. If you’d like to invite a guest or add an additional person to your session, please contact your facilitator in advance to ensure availability.* This field is required..

AcceptDecline

7

Session start and end times are fixed. If you arrive late or need to step away in the middle of the session, the facilitator will still end at the scheduled time.* This field is required..

AcceptDecline

8

Private sessions and group bookings can be rescheduled without penalty with at least 24 hours advance notice. If less than 24 hours' notice is given, a $25 late/cancel fee will be charged.* This field is required..

AcceptDecline

9

I understand that my facilitator is not a clinician and cannot treat, diagnose, or cure any disease, illness, or injury. In all cases, you should join sessions with approval from a trusted medical professional and should always follow their doctor’s advice.* This field is required..

AcceptDecline

10

You take full responsibility for your own health and any illness or injury that may occur. You cannot and will not hold instructors or any employers or affiliates responsible in the case of accident or illness during practice.* This field is required..

AcceptDecline

11

I am providing my contact information for session registration, updates, marketing, and communication. I can opt-out and cancel/remove my complete data at any time by contacting my facilitator.* This field is required..

AcceptDecline

12

I have read and understand the terms and conditions of sessions as outlined previously.* This field is required..

AcceptDecline

13

Signature* This field is required.

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