Waiver of Liability and Informed Consent Release

Your privacy is important and your information will not be shared under any circumstances.

Participant Information

All information collected by Gerattil Pilates is kept confidential. We prioritize the privacy of our clients and do not share personal data without consent. I, the undersigned participant, hereby acknowledge that I have voluntarily chosen to participate in physical activity and exercise sessions provided by Geratti Pilates.

I affirm that the information provided below is accurate to the best of my knowledge:

I understand and agree to the following terms and conditions:

Name

First Name

Last Name

Date of Birth

YYYY

Phone

(###)

###

####

Emergency Contact

First Name

Last Name

Emergency’s Contact Phone Number

(###)

###

####

Check all that apply

First time doing Pilates

Have done Pilates before

Do you have any recent injuries?

If yes, have you been cleared by a doctor to exercise?

Write N/A if the answer to previous question is no.

Read Carefully

I have been advised and I understand that participation in the Pilates method of physical conditioning, like any physical conditioning activity or exercise program, presents some unavoidable risk of injury, especially to people who have pre-existing injuries, illness or medical disabilities. I understand that the use of exercise equipment also carries with it a risk of injury. I recognize that I may experience changes as a result of participation in the Pilates method of physical conditioning, including possible short-term aggravation of some symptoms, feeling of tiredness, light-headedness, increased energy, etc. I accept full responsibility and liability of all above mentioned risks, possible injury, and/or changes. Should there be any change in my condition or medication, I shall inform my instructor accordingly prior to class. I understand that if I have not participated in an exercise program for some time or have an underlying condition, I should consult my doctor before I begin. I understand that exercise may cause injury and/or discomfort, and I fully accept responsibility. I will inform the instructor and stop immediately should I feel dizziness, pain or any feeling that may suggest exercise is causing me a problem. Release of Liability: I hereby release, waive, discharge, and covenant not to sue Geratti Pilates, its owners, instructors, employees, and agents from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, whether caused by the negligence of Geratti Pilates or otherwise. Medical Clearance: I affirm that I am in good physical condition and have no medical conditions or limitations that would prevent me from participating in Pilates exercises. I agree to inform Geratti Pilates of any changes in my medical condition or limitations. Emergency Medical Treatment: In the event of an emergency, I authorize Geratti Pilates and its staff to obtain medical treatment for me, including but not limited to emergency medical services and transportation to a medical facility, as deemed necessary.

Checkbox

By checking this box, I acknowledge that I have read this Waiver of Liability and Informed Consent Release, fully understand its terms, and voluntarily agree to its contents.

Waiver of Liability and Informed Consent Release

Geratti pilates

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