Online Consent
I hereby agree to the following:
1. That I am participating in the classes, health programs, workshops or services offered by Mirror Image Fitness and Wellness Studio, during which I will receive information and instruction or other services offered pertaining to fitness and health. I recognize that exercise requires physical exertion which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in exercise classes, health programs, workshops or services. I represent and warrant that I am physically fit and I have no medical conditions which would prevent my full participation in the exercise classes, health programs, workshops or services.
3. In consideration of being permitted to participate or receiving services, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the program or receiving any services.
4. In further consideration of being permitted to participate in the classes, I knowingly, voluntarily and expressly waive any claim I may have against Mirror Image Fitness and Wellness Studio for injury or damages that I may sustain as a result of participating in the program or from receiving any services.
5. I, and my heirs or legal representatives forever release, waive, discharge and covenant not to sue Mirror Image Fitness, LLC or any company within, for injury or death caused by their negligence or other acts. I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions listed above.
I hereby grant full permission to any and all of the foregoing to use any photographs, motion pictures, recordings, or any other record of this class for any legitimate purpose including commercial advertising, without monetary payment to me.
The undersigned agrees that this is the full agreement between the parties. That Mirror Image Fitness nor anyone else has verbally contradicted any of the terms of this release and that the undersigned has entered into this agreement free and voluntarily without force or coercion.
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By entering your name in the Signature box and the date in the date box, you agree to the provisions of this agreement.
(Parent or Guardian Signature if participant is under 18 years old)
