Zumba Gold Registration and Waiver for October

Welcome to Zumba Gold!

We are excited to have Bette Lewin back with us on October 9, 16, and 30th at 1pm.

Each class is approximately 1 hour in duration followed by light refreshments and snacks.

Everyone of all physical abilities is welcome to join in the fun!

The cost for October is $15.00; with this registration fee you can join 1, 2, or all 3 classes. Your registration fee can be left with the parish office in a marked enveloped labeled Zumba - Attn Tanya, or an email can be sent to btfamilylife@gmail.com indicating that the fee will be remitted at the first class.

Wondering what you need to wear or bring? It's simple -- wear comfy cloths and running shoes (sandals should not be worn for Zumba) and bring a water bottle and a smile!

Looking forward to seeing you this October! Reach out to Tanya at btfamilylife@gmail.com if you have any questions.

Name*

First NameLast Name

Email*

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Phone Number*

Please enter a valid phone number.

I understand that my registration gives me access to 3 Zumba Gold Class/classes to be held at Blessed Trinity Parish, 3220 Bayview Avenue, Toronto, Ontario. The classes are October 9th, 16th, and 30th at 1pm.*

I understand.

This class is for individuals 55 years of age and older.*

I am 55 years of age or olderI am UNDER 55 years old

AGREEMENT AND WAIVER / RELEASE OF LIABILITY for the Roman Catholic Episcopal Corporation for the Diocese of Toronto, in Canada (Archdiocese of Toronto) including but not limited to Blessed Trinity Parish. In consideration for being allowed to participate in this activity, which I do freely and voluntarily for my own personal benefit, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors and assigns and agree to the following statements:*

I desire to engage voluntarily in any group exercise class such as but not limited to, Zumba Gold with Bette Lewin, being held at Blessed Trinity Parish, 3220 Bayview Avenue, Toronto, Ontario.I understand that the activities may be strenuous, and may require me to do body movement that I am not familiar with in order to improve overall fitness. I understand that I am responsible for monitoring my own condition throughout the group exercise class. Should any unusual symptoms occur, I will cease my participation.I 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 the Archdiocese of Toronto, its insurers, employees, officers, directors, and associates, 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 group exercise class and facilities.I contract on behalf of myself, my heirs, executors, administrators, successors and assigns, that Archdiocese of Toronto or Blessed Trinity Parish and its insurers, employees, appointed instructors, officers, directors, and associates, shall not be liable for any damages arising from personal injuries (including death) sustained by me in, on, or about the premises, or as a result of participating in any group exercise class and/or the use of the facilities, regardless of whether such injuries result, in whole or in part, from the negligence of the Archdiocese of Toronto.I understand that the Archdiocese of Toronto is not responsible for property that is lost, stolen, or damaged while in, on, or about the premises.I understand I am solely responsible for safety and wellbeing of myself.I release, hold harmless and forever discharge the Archdiocese of Toronto and/or Blessed Trinity Parish staff, appointed instructors, contractors, caregivers, volunteers, directors, employees and affiliates, from any and all liability, claims, losses, damages, costs or expenses, and waive any such claims against and such persons or organizations, arising directly or indirectly from, or attributable in connection with all group exercise activities and programs, onsite through the sponsorship and organization of the Archdiocese of Toronto.

Emergency Contact Name*

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Emergency Contact Phone Number*

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Date*

Date

In signing this consent form, I affirm that I have read, accept and understand this form in its entirety and that I understand the nature of exercise. I know that there may be risks associated with exercise/fitness programs and willingly accept those possibilities. I know that it is my responsibility to ensure my own safety. I take full responsibility for my own health and safety in participating in the exercise/ fitness class and to the extent I deem advisable, will consult a physician before participating in any of the activities. (Use your mouse or finger if you have a touch screen to insert your signature below).