Waiver to Participate | The Wellness Vault

If you are attending a private event at The Wellness Vault, we kindly ask that you review and sign our participation agreement. If you are attending a regularly scheduled class, this waiver will be completed in our scheduling software.

Participation Agreement and Waiver of Liability

First Name

Last Name

Date of Birth

Phone

*If you have any medical conditions our instructors should be aware of, you must notify us before the start of class. If you have any injuries that require workout modifications please notify us before the start of class.

By completing and signing this form, I hereby agree to the following:

1. That I am participating in a Class, Workshop, or Session offered by The Wellness Vault, LLC during which I will receive information/instruction about my desired class. I recognize that these classes may require some physical exertion, which may be strenuous and may cause physical injury. I am fully aware of the risks and/or hazards involved.

2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any Class, Workshop, or Session. I certify that I am physically fit and I have no undisclosed medical condition, which would prevent my full participation in a Class, Workshop or Session offered by The Wellness Vault, LLC.

3. 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 any fitness program at The Wellness Vault, LLC, including hot or warm temperature yoga.

4. I knowingly, voluntarily and expressly waive any claim that I may have against The Wellness Vault, LLC its instructors and staff, and its owners, for any injury, death or damages that I may sustain as a result of being in The Wellness Vault, LLC facility or as a result of participating in a Class, Workshop or Session; including loss that may be caused by the negligence of the released party.

5. I release and discharge The Wellness Vault, LLC, its directors, owners, staff and its instructors from any and all liability, claim, demand or action that I may have related to the loss, theft or damage of any of my personal property while The Wellness Vault, LLC facility.

6. I, my heirs or legal representatives, forever release, waive, discharge and covenant negligence or other acts.

I have read the above release and waiver of liability and fully understand its contents.

I am 18 years of age or older and voluntarily agree to the terms and conditions stated above.

Participants Signature

Date

If the participant is under 18 years of age --

As a legal guardian of:

Participant's Name

I consent to the above conditions and terms.

Signature

Date

Thanks for submitting!