I will receive information and instruction while participating in the class at Hilary Opheim Pilates. I recognize that this class will require physical exertion, which may be strenuous and may cause physical injury and I am fully aware of the risks and hazards involved. *

Yes

I understand that it is my responsibility to consult with a physician prior to and regarding my participation in this class or any other activity associated with Hilary Opheim Pilates. I represent and warrant that I am physically fit and I have no medical conditions, which would prevent my full participation in the Pilates workout. If I have any medical conditions they are listed clearly and accurately on the Client Information form *

Yes

I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I may incur as a result of participating in the program. *

Yes

I knowingly, voluntarily and expressly waive any claim that I may have against Hilary Opheim Pilates. teacher or Hilary Opheim Pilates for injury or damages that I may sustain as a result of my participation. *

Yes

Heirs, my legal representatives or I, forever release and waive any liabilities against Hilary Opheim Pilates and it’s instructors for any injury or death incurred by my voluntary participation in this class. *

Yes

An inherent risk of exposure to COVID-19 exists in any public place where people are present. COVID-19 is an extremely contagious disease that can lead to severe illness and death. According to the Centers for Disease Control and Prevention, senior citizens and guests with underlying medical conditions are especially vulnerable. I voluntarily assume all risks related to exposure to COVID-19. *

Yes

I HAVE READ THE ABOVE RELEASE & WAIVER OF LIABILITY AND FULLY UNDERSTAND ITS CONTENTS. I VOLUNTARILY AGREE TO THE TERMS AND CONDITIONS STATED ABOVE. *

Yes I do

I agree to all above *

Yes

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