Terms and Conditions: Informed Consent Agreement of Liability Release and Waiver

 

 

“The following Release and Waiver of Liability agreement was drafted based on Illinois law.  Please check with local counsel prior to using the enclosed Release in your own membership agreement for any applicable modifications.”

 

 

I hereby agree to the following:

 

1.          That I am participating in the Pole Dancing & Yoga Classes, Programs or Workshops (online and in-person) offered by Aerial Graffiti, LLC (dba Fly Club), during which I have received information and instruction about health and fitness.  I recognize that fitness programs require physical exertion that may be strenuous and may cause physical injury. I am fully aware of the risks and hazards involved with participation in an exercise program.

 

2.          I understand that Pole Dancing and Yoga are forms of physical activity with the purpose of increasing my body awareness, core strength, balance, breath control, overall strength and flexibility, and to help foster self confidence.  The exercises may be done on a mat, floor, chair, or with quality equipment designed for this purpose. I understand that whether I am working in a private or group session (via online or in-person instruction), my instructor has my best interest in mind and I will communicate if an exercise is uncomfortable at any time.  I agree to listen to my instructor and heed all warnings, cautions, and instructions during all workouts to ensure my safety.

 

I understand that exercises on Pole Dancing & Yoga equipment incur risks. I accept these risks and do not hold the instructor or studio responsible should any injury result in relation to said equipment. I acknowledge that neither instructor studio can be held liable for faulty installation and/or use of Pole Dancing & Yoga equipment outside of the physical studio space of Aerial Graffiti, LLC (dba Fly Club), specifically related to home poles and equipment.

 

3.          I understand that it is my responsibility to consult with a physician prior to and regarding my participation in Pole Dancing & Yoga Classes, Programs, or Workshops (both online and in-person).  I recognize that exercise carries some intrinsic risks to the musculoskeletal system (sprains, strains) and the cardio-respiratory system (dizziness, difficulty breathing, heart strain). I hereby acknowledge and accept these risks. I agree to inform my instructor immediately should I start to feel unwell during the exercise. To my knowledge, I have neither limiting physical conditions nor disability that would preclude an exercise program.  I represent and warrant that I am physically fit.

 

4.           In consideration of being permitted to participate in Pole Dancing & Yoga Classes, Programs, or Workshops (online and in-person), 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 the exercise program.

 

5.           In consideration of being permitted to participate in Pole Dancing & Yoga Classes, Programs, or Workshops (online and in-person), I knowingly, voluntarily, and expressly waive any claim I may have against Aerial Graffiti, LLC (dba Fly Club) for injury or damages I may sustain as a result of participating in the program.

 

6.           I, my heirs, or legal representatives forever release, waive, discharge, and covenant not to sue Aerial Graffti, LLC (dba Fly Club) for any injury or death caused by their negligence or other acts.

 

I have read the above release and waiver of liability and fully understand its contents.  I voluntarily agree to the terms and conditions stated above. I agree to use electronic records and signatures.

 

I hereby grant Fly Club permission to take, use, reuse, and publish: photographs and/or videos of me in any and all of its publications and in any and all other media.