Balanced Classes Sign Up

Form
Email*
example@example.com
Name*

First NameLast Name
Phone Number
Please enter a valid phone number.
What day and time are you wanting to attend?

Wednesday, February 4th, 2026 at 10amTuesday, February 10th, 2026 at 12:30pmWednesday, February 11th, 2026 at 10amWednesday, February 18th, 2026 at 10amTuesday, February 24th, 2026 at 12:30pmWednesday, February 25th, 2026 at 10am
Do you have any injuries we should be aware of?
By checking the box below, you are signing and agreeing to this Liability Waiver.RELEASE OF LIABILITY AND ASSUMPTION OF RISK1. I understand that physical exercise and training, including the use of equipment and participationin dietary programs (collectively, “Training”), is a potentially dangerous activity and involves the risk ofserious injury, disability, death, and property damage. I acknowledge that these risks may result or becompounded by the actions, omissions, or negligence of my personal physical trainer (the “Trainer”) or others.I understand that although the Trainer will endeavor to reduce the risk of injury from Training, the Trainercannot guarantee that I will not be injured. NOTWITHSTANDING THESE RISKS, I ACKNOWLEDGETHAT I AM VOLUNTARILY PARTICIPATING IN TRAINING. I AGREE TO ASSUME ALL RISKS OFILLNESS, PERSONAL INJURY, PSYCHOLOGICAL INJURY, PAIN, SUFFERING, DISABILITY,DEATH, PROPERTY DAMAGE, AND FINANCIAL LOSS ARISING THEREFROM, WHETHER CAUSEDBY THE ORDINARY NEGLIGENCE OF THE TRAINER OR OTHERWISE.2. I waive and release all claims, now known or hereafter known, against the Trainer on account ofpersonal or psychological injury, illness, pain, suffering, disability, death, property damage, or financial lossarising out of or attributable to Training, whether arising out of the ordinary negligence of the Trainer orotherwise. I agree not to make or bring any such claim against the Trainer, and forever release and discharge theTrainer from liability under such claims.3. I confirm that I am in good health and proper physical condition and do not have any medical orother conditions that would impair my ability to participate in Training and I will also follow all instructions,recommendations, and cautions of the Trainer at all times during Training. If at any time I believe that I am nolonger in proper physical condition to participate in Training, I will immediately discontinue further Training.4. I hereby consent to receive medical treatment deemed necessary if I am injured or requiremedical attention during Training. I understand and agree that I am solely responsible for all costs related tosuch medical treatment and any related medical transportation and evacuation. I release, forever discharge, andhold harmless the Trainer from any claim based on such treatment or other medical services.5. This release may not be orally modified and constitutes the entire agreement of the Trainer andme with respect to the subject matter contained herein and supersedes all prior and contemporaneousagreements, both written and oral, with respect to such subject matter. If any term or provision of this release isdeemed invalid, illegal, or unenforceable, all other terms or provisions shall remain in full force and effect.6. BY SIGNING, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD ALL OFTHE TERMS OF THIS RELEASE AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIALLEGAL RIGHTS, INCLUDING THE RIGHT TO SUE THE TRAINER.*

Yes, I understand.
To secure your spot: Please venmo, zelle or complete an invoice to secure your spot! You will receive an email from me with invoice options within 24 hours of completing this form. If booking multiple classes, a membership may be the cheapest! Venmo: rhynelisab. Zelle: 336-782-7723. One class $30.
https://account.venmo.com/u/rhynelisab
Should be Empty:

Form