Liability Waiver & Participant Information
Pilates & Barre Movement Studio LLC.
950 Puget St. Bellingham WA
Full Name *
Date of Birth *
Street Address *
City *
State *
ZIP *
Phone Number *
Email Address
Acknowledgment of Risks
I, the undersigned, acknowledge that I am voluntarily participating in fitness activities at Pilates and Barre Movement Studio LLC. I understand that these activities involve physical exertion and may carry certain risks, including but not limited to, the risk of injury or death. I confirm that I am physically capable of participating in these activities.
Photo Release
I, the undersigned, hereby grant permission to Pilates and Barre Movement Studio LLC, its representatives, and employees the right to take photographs and videos of me in connection with my participation in classes and events at the studio. I understand that these images may be used for promotional purposes, including but not limited to advertising, social media, and marketing materials. I acknowledge that I will not receive any compensation for the use of these images.
Medical Emergency
In the event of an emergency, I authorize the studio staff to seek medical treatment on my behalf if necessary.
Emergency Contact Name / Relation *
Emergency Phone Number *
By signing below, I acknowledge that I have read and understood this waiver, and I agree to its terms.
Participant Signature (type your full name) *
Date
Parent/Guardian Signature (if under 18)
Version 1.0 · Bespoke Studio · (360) 878-3961