Tai Chi Intro / Drop-In Session

Tai Chi

Intro / Drop-In Session
Tai Chi

First time participants or occasional practice

Learn Tai Chi to regain benefits of movement mindfulness, and internal and external balance, with our Tai Chi for Health instructor, Certified Exercise Expert for Aging Adult and Chronic Pain Coach, Nina Evangelista, PT.

Tai chi is a low-impact impact exercise that’s gentle on the joints.

For more information visit https://aaaphysicaltherapy.com/tai-chi-classes/

Participation Agreement
Voluntary Participation

I understand I am voluntarily participating in wellness programs involving movement, education, and fitness activities.

Wellness Services Disclaimer

I understand these programs are wellness and educational services and are not physical therapy treatment, medical diagnosis, or individualized healthcare services unless I am separately enrolled as a patient of AAA Physical Therapy under a formal plan of care.

Participation does not establish a provider-patient relationship.

Assumption of Risk

I understand physical activity involves risks including:

• Muscle soreness
• Strains or sprains
• Loss of balance
• Falls
• Fatigue
• Temporary discomfort

I agree to participate safely and within my personal limits.

Health Responsibility

I agree that:

• I am responsible for monitoring my own condition
• I will modify exercises as instructed
• I will stop if I experience pain or symptoms
• I will seek medical clearance if needed

Release of Liability

I release AAA Physical Therapy & Lifestyle Club, its owner, instructors, employees, and partners from liability for injuries resulting from participation except in cases of gross negligence.
Photo & Media Release*

YES I allow photos/videos for community and promotional useNO I prefer not to be included
Community Participation Standards. To maintain a safe environment I agree to:*

Follow instructor safety guidanceRespect other participantsParticipate appropriatelyAsk questions if unsure
Cancellation & Refund Policy

Workshops and wellness services subscription fees are non-refundable.

Program Selection Section:
Which program are you registering for?*

Tai ChiLifestyle Club MembershipFloor ConfidenceGarden Strong/ Travel StrongMovement Longevity LabStyku Body Scan and CoachingCommunity WorkshopGuest of Member RegistrationOther
Participant Agreement:
By registering I confirm:*

I understand this is a wellness program and payment is for wellness servicesI understand this is not medical treatmentI accept participation risksI agree to the policies aboveI am not currently receiving PT elsewhere for the same conditionI understand wellness services are separate from insurance PT
Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Emergency Contact*

First NameLast Name
Emergency Contact Number*

Area CodePhone Number
Do you have any difficulty moving? *
Date of Tai Chi Session to Attend

MonthDayYear
DateHourMinutesAM/PM Option
Signature*
Should be Empty: