Since Sep 2014

Gloria GoyaZumba

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WAIVER FORM 


**Please read carefully, sign below and bring to class**



I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition/s which would prevent or limit my participation in this exercise program.


I recognise that any physical fitness program, including group fitness classes and outdoor boot camp sessions involve strenuous physical activity, including but not limited to, strength and endurance training, cardiovascular conditioning and training.


I hereby acknowledge that my participation in Gloria del Fierro’s  classes, personal training/ boot camp sessions may expose me to unforeseen injury or accidents. I fully understand that I may injure myself as a result of my enrollment and subsequent participation in this program.


I knowingly, freely and voluntarily assume all risks and responsibilities while participating.and hereby release Gloria del Fierro and her associates from any claims, demands and causes of action as a result of participation and enrollment.


I waive any and all liability and negligence to Gloria del Fierro, Zumba Licensed Instructor in the execution of her exercise fitness program.

I hereby release Gloria del Fierro and her associates from any liability now or in the future for conditions that may occur such as, but not limited to heart attacks, strokes, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, injuries to knees or other joints to the body, injuries to the back, injuries of the foot, heat exhaustion, heat stroke, or any other illness or physical damages that may lead to disability or even death.


I HEREBY AFFIRM THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE STATEMENTS



Full Printed Name...............................................................................................Date...............................



Signed.....................................................................


Consult your medical practitioner before beginning this or any other exercise program.

The instructions and advice presented are in no way intended to be a substitute for medical counselling.

Not all exercises are suitable for everyone and this or any other exercise program may result in injury

Any user of this exercise program assumes the risk of injury resulting from performing the excercises shown.

I, Gloria del Fierro, Zumba licensed instructor disclaim any liability or loss in connection with the exercise and advice contained herein.