Assumption of Risk and Release of Liability Agreement

Assumption of Risk and Release of Liability Agreement
I, the undersigned, assume all responsibility for and all the risk of damage or injury that may occur as a result of my own actions, inactions, or negligence, or that of others as a client of Flo Pilates Studio.

In consideration of and as part of payment for the right to participate as a client of Flo Pilates Studio, I will hold harmless, and release and discharge all rights and claims for damages that I may have or that may hereafter accrue to me against Flo Pilates Studio, its owner, employees, and agents for any and all injuries resulting from or arising out of, or incident to, my use of Flo Pilates Studio or as a result of, or incident to, engaging in Flo Pilates Studio exercises or otherwise following Flo Pilates Studio instructions anywhere.

The terms hereof shall serve as a release, indemnification, and assumption of risk for my heirs, executors, and administrators, and for all members of my family. I have made the decision to participate in this program with/without consulting my physician.
Today's Date*

MonthDayYear
Date
Full Name*

First NameMiddle NameLast Name
Are you over the age of 18?*
Name of Parent/Guardian if under the age of 18

First NameLast Name
I Acknowledge the above agreement*

Agree
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