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  • Revival PT & Wellness Workshop Registration

    Complete the from below to sign up for the workshop
  • Workshop Liability Waiver

    Our staff will be conducting a workshop for anyone who wishes to participate. During the workshop, we will provide each participant with simple exercises and/or stretches to perform at home to reduce the risk of injury and enhance performance, strength, and stability. The purpose of this workshop is not to diagnose or treat any injuries. While the screening will be performed by trained individuals, participating in the workshop carries a risk of injury that cannot be eliminated, regardless of the care taken to avoid such injuries. The undersigned individual assumes all risks by participating in the workshop. By signing below and in consideration for the aforementioned workshop, I waive and forever release any and all rights and claims for damages and liabilities of any kind arising out of my participation in this workshop against all persons, entities, and agencies involved in performing the workshop, including but not limited to Revival Physical Therapy & Wellness or any other related individuals or entities. I understand that this workshop is not intended to diagnose or treat any injuries, but to assist with optimizing movement for the participant. I also understand that my participation in this workshop does not guarantee injury prevention or performance enhancement. The results will not be shared with any individuals or entities except as outlined herein and will only be used for informational purposes, including tracking of injuries and/or trends. I agree to be contacted by Revival Physical Therapy & Wellness in the future. We will not share your personal information, per Revival Physical Therapy & Wellness' Privacy Policy. I have carefully read this waiver of liability and understand that I am giving up legal rights, including my right to sue. I acknowledge that I am signing this waiver freely and voluntarily and intend by my signature to be a complete and unconditional release of all liability to the extent allowed by law.

    By typing my name below, I agree to the statements in this document. This will serve as my electronic signature.

     

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    Payment Methods

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