Whole Health Mobile Registration
Name
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First Name
Last Name
Email
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example@example.com
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Waiver
*
In consideration of participation in activities related to Bella Sundries Studios/Integrity Defense Academy, I represent that I understand the nature of this Activity and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I acknowledge that if I believe conditions are unsafe, I will immediately discontinue participation in the Activity. I fully understand that this Activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or inactions, those of others participation in the Activity, the conditions in which the event takes place, or the negligence of the “releases” named below. I fully accept and assume all such risks and all responsibility for losses, cost, and damages I incur as a result of my participation in the Activity. I hereby release, discharge, and covenant not to sue Bella Sundries Studios or Integrity Defense Academy, its respective administrators, directors, agents, officers, volunteers, employees, other participants, sponsors, advertisers and, if applicable, owners and lessors of premises on which the Activity takes place (each considered one of the RELEASEES herein), from all liability, claims, demands, losses, or damages on my account caused in whole or in part by the negligence of the “releases” or otherwise, including negligent rescue operations and future agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes a claim against any of the Releases, I will indemnify, save, and hold harmless each of the Releases from any loss, liability, damage, or cost, which any may incur as the result of such claim. Any and all Activities will be conducted in a safe environment and will hold Bella Sundries Studios and Integrity Defense Academy harmless of any injuries incurred in areas of operation. I have read the Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.
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My Products
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Kids Yoga
$
60.00
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Recurring payments
Adult Yoga
$
90.00
for each
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Unlimited
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Recurring payments
Martial Arts (kids or adults)
$
159.00
for each
month
Unlimited
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Recurring payments
Unlimited Yoga and Martial Arts
$
225.00
for each
month
Unlimited
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Recurring payments
Credit Card
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