Enrollment and Waiver Agreement Name (Please Print) Name________________________________________________________
Parent/Guardian Name (If applicable)_______________________________ Address______________________________________________________
City _____________________State__________ Zip Code______________ Phone______________ E-Mail ________________________________
Date of Birth: ________________________
Allergies/Medical Issues: _____________________________
Acknowledgment and Assumption of Risk I, the undersigned participant or parent/guardian (if participant is under the age of eighteen), acknowledges and agrees that group fitness classes are athletic activities and that there are certain risks and hazards inherent in and associated with any such activity, individually, or with, or among others.
In consideration of enrollment in programs of, and participation in the activities at the facilities of, and/or sponsored by, Sara Wagner and Studio FIT LLC, the participant herby accepts and assumes all such risks and hazards and waives any and all claims of liability against Sara Wagner and Studio FIT LLC, the facility, their agents, officers, principles or employees for any injury or damage arising out of or in connection with such risks and hazards. Participant further acknowledges that some instructors are independent contractors and are not the employees, agents, servants or partners of Sara Wagner and Studio FIT LLC. Sara Wagner and Studio FIT LCC make no representation or warranty with regard about any such instructor or the instruction provided thereby.
Participant further accepts and assumes full responsibility for the adequacy and suitability of his/her physical condition for the activities in which he/she engages at said facilities, and further acknowledges that Sara Wagner and Studio FIT LLC reserve the right to limit, restrict, or terminate participantʼs access to and/or the use of facilities for any other participants, including, in addition to the foregoing, such rules and procedure put into effect by Sara Wagner and Studio FIT. The participant fully consents to emergency medical care rendered by a competent personnel or hospitals, should such attention become necessary during the activities, programs or special events.
Payment: Participant further acknowledges that payment for said activities, programs, or events is due at time of service. If the participantʼs payment is returned, rejected or denied from the participantʼs financial institution, participant shall be charged a $25.00 fee including the initial cost of charges or payment amount by way of certified funds within 14 days of the date service was provided.
Photo Waiver: Participant hereby fully consents to allow Sara Wagner and Studio FIT LLC to take photographs and videos at or in the vicinity of the facilities for security or advertising or other purposes and participants waive any rights to their appearances in such photographs or videos.
Email Communication: By providing email information the participant consents to receive occasional email communications about programs, services and events provided by Sara Wagner and Studio FIT LLC. Participant understands their email address WILL NOT be disclosed to any other organization, and may be unsubscribed to this service at any time.