Participant Waiver and Release of Liability Strength In Motherhood Fitness Classes
Please read carefully before signing
Full Name
First Name
Last Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.
List all adults and children attending the class.
Acknowledgment of Risk
I Agree
Medical Clearance
I Agree
Release and Waiver
I Agree
Photo/Media Release (Optional) I give permission for photos or videos of myself and/or my child taken during the program to be used for promotional purposes.
Yes
No
Parental Responsibility I understand that I am responsible for supervising my child(ren) at all times during the program. I acknowledge that this is not a childcare service and that my child(ren) must remain under my direct care and supervision.
I Agree
Signature
*
Submit
Submit
Should be Empty: