Waiver Form

Kinect Pilates

PILATES WAIVER OF LIABILITY AND INFORMED CONSENT RELEASE

This Release, Waiver and Hold Harmless Agreement is made by and between the undersigned (client) and Kinect Pilates (Cheryl Reynolds), and entered into on the day month and year below.

Kinect Pilates and instructor Cheryl Reynolds provide space for instruction, in studio and online, in the Pilates method of physical conditioning. The parties to this agreement recognize that participation in this activity could lead to physical injury to the client.

Client desires to undertake Kinect Pilates’ (Cheryl Reynolds) program with the full knowledge of the possibility that physical injuries could result from it and assumes the risk of any such injury.

The parties recognize that Kinect Pilates and instructor Cheryl Reynolds will not be able to provide its program to client without the execution of the agreement.

Therefore, the client in consideration of the above and the exercise classes to be provided, hereby waives all claims for damage or loss to person or property which may be caused by any act, or failure to act of Kinect Pilates instructors, staff or employees. Client assumes risk of all dangerous conditions in and around the premises and waives any and all specific notice of the existence of such conditions. Client also assumes the risk of any and all injuries that might result from participating in Kinect Pilates and Cheryl Reynolds exercise programs.

I ___________________________ have enrolled in a program of physical activity including but not limited to the use of various Pilates machinery offered by Kinect Pilates and instructor Cheryl Reynolds. I understand that participation in the Pilates Method of exercise and conditioning activities, like any physical conditioning activity or exercise program, presents some unavoidable risk of injury, especially to people who have pre-existing injuries, muscle/movement patterns, illness or medical disabilities.

I hereby affirm that I have and will keep Kinect Pilates and instructor Cheryl Reynolds informed of any existing physical condition or disability which would prevent or limit my participation in an exercise or physical-conditioning program. I will also keep Kinect Pilates and instructor Cheryl Reynolds informed of any physical condition or disability arising from my participation in the exercise program.

In consideration of my participation in Kinect Pilates exercise program, I my heirs and assigns, herby release Kinect Pilates (its employees and owners), from any claims, demands and causes of action arising from my participation in the exercise program

I fully understand that I may injure myself as a result of my participation in Kinect Pilates exercise program and I hereby release Kinect Pilates (its employees and owners) from any liability, now and in the future, including but not limited to heart attacks, muscle strains/pulls or tears, broken bones, shin splints, heat prostration, knee/lower back/foot injuries and any other illness, soreness, or injury however caused, occurring during or after my participation in the exercise program.

On behalf of myself and my heirs, personal representatives and assigns, I hereby release, waive, covenant not to sue, and forever discharge Kinect Pilates and its officers, directors, agents, and employees, from any and all claims, demands, rights, causes of action, judgments, costs and expenses (including reasonable attorneys’ fees) or other liability of whatsoever kind or nature resulting from my participation in or in any way connected with the program(s) and/or use of the facilities or equipment of Kinect Pilates, including but not limited to, any and all bodily and personal injuries (including death) or damage to property.

I hereby affirm that I have read and fully understand the above, am over eighteen years of age, or am a legally emancipated minor.