Registration, Liability and Consent

Gym Class Registration

Name (Parent)

First Name

Last Name

Email

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name (Child)

If there is more than 1 child participating please add them below (Participant Information).

First Name

Last Name

Participant Information

Please provide the NAME and AGE of each person who will be participating.

Select

Number of Participants

Signature

Recordings: Terms and Conditions Cancellation and Liability Information Cancellation Policy: Once registered for recordings, there is a zero cancellation policy. That means that you cannot cancel your registration for recordings once you have paid for them. Final Sale. No refunds, class credit or make up sessions. Liability: Your agreement to this set of sessions and all ensuing sessions with Jennifer Derago and Hello Pilates means that you agree to the following: I understand that I have enrolled in a program of strenuous physical activity including but not limited to body-conditioning equipment and/or props used during my workouts. I hereby absolve Jennifer Derago and Hello Pilates from any responsibility for injuries I might sustain while practicing the Pilates method of body conditioning or any actions learned with or by Jennifer Derago and Hello Pilates. I hereby release for myself, my heirs and assigns, Jennifer Derago, Hello Pilates, (and its employees) from any claims, demands and causes of actions arising from my participation in an exercise program. Agreement to this Cancellation and Liability Information will act as your continued agreement to all ensuing sessions, classes and/or workshops whether in person, via iChat, Skype, Zoom or any other video conferencing tool. *I have read and agree to the terms above. You are signing for yourself and behalf of a minor.