Waiver of Liability and Prospective Release Form for Studio Pilates International
I declare that I am over 18 years of age (or have otherwise provided parental consent) and acknowledge and understand that I have voluntarily chosen to participate in the classes and activities offered by a franchisee of Studio Pilates International USA Corp. (“Franchisor, Franchisee and their affiliated and parent companies are jointly referred to as ”Studio Pilates International”).
I acknowledge and agree that the workouts are a recreational sports activity and may involve strenuous physical activity including, but not limited to stretches, lifts, use of props, use of reformer machines, gymnastic movements, strenuous bodyweight exercises and other strenuous activities that I am not obliged to perform, nor am I obliged to participate in any activity that I do not wish to do, and that it is my right to refuse such participation at any time during classes.
I understand that there are inherent risks in all aspects of physical exercise and I acknowledge that I have been informed of the possible strenuous nature of training. I agree that prior to my participation I will inform Studio Pilates International of any known medical conditions or factors that may place me at risk. Studio Pilates International may request a medical release from my medical practitioner prior to participation. I will inform Studio Pilates International of any symptoms before, during and after participation in a Studio Pilates International class.
I also understand that if I am a prenatal or postnatal client, I must consult with my physician and receive clearance to perform physical exercise.
I release Studio Pilates International and its staff, employers and agents from any and all liability for any loss, damage, injury or expense that I may suffer, or that my next of kin may suffer as a result of my participation in the classes, activities and services provided by Studio Pilates International. I knowingly waive the right to a jury trial and the right to punitive damages in connection with any claim arising out of or relating to my participation in such classes, activities, and services, or this waiver and prospective release.
I agree to hold harmless and indemnify Studio Pilates International and its employees and agents from any and all liability for any damage to the property of, or personal injury to, any third party, resulting from my participation in any program, activity or service provided by Studio Pilates International. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full force and effect.
In checking the box below I agree that I have not experienced any injury, back, neck or joint pain, restricted movement, heart issues, asthma, or high or low blood pressure, arthritis, slipped or bulging vertebral disk, pelvic floor conditions, dizziness, diabetes, epilepsy, hernia, bone degeneration, high cholesterol, allergies or chronic illness. I also declare that I have notified Studio Pilates if I am pregnant and/or have given birth in the last 12 months, or if I have undergone surgery in the past 12 months.
If any of the above health conditions apply to you, please include full details in this form.
Studio Pilates International shall not undertake any obligation (whether contractually, at common law or otherwise) to advise or treat me in relation to any of the matters referred to in the preceding paragraph. I acknowledge that it is my obligation and mine alone to take responsibility for my health and wellbeing during any type of exercise I undertake with Studio Pilates International.
By checking this box below, I acknowledge that Studio Pilates International shall not be liable or responsible to me for articles lost, damaged or stolen from any of its studios.
By checking the box below I also acknowledge that I am aware that to ensure that Studio Pilates International is able to provide me with the best possible service, all studios have been fitted with CCTV cameras and audio that are operated on an ongoing basis. These cameras and audio are used strictly for security, protection and training purposes only. Access to this footage is restricted and can only be viewed by authorised personnel.
I understand that from time to time Studio Pilates International and/or its employees or contractors may film or photograph the classes, activities or services provided by Studio Pilates International. By checking the box below, I permit Studio Pilates International and its licensees or assignees to use, publish, reproduce, distribute, create derivative works of, perform, display and/or otherwise exploit my name, image, voice and likeness, either complete or in part, alone or in conjunction with any wording, for uses including publicity and/or merchandising and/or editorial purposes in any country in connection with any part of the business of Studio Pilates International in any manner and in all forms of media whether now existing or developed in the future. I hereby waive any right to inspect and approve the photographs or videos or the printed/digital/electronic matter that may be used in conjunction with them now or in the future, regardless of whether that use is known or unknown. I waive any right to copyright or royalties or other compensation from or related to use of the photography or videos or adaptations thereof.
I have read the above release form and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.
I acknowledge that this waiver may be pleaded in response as a bar to any legal proceeding taken by me or on my behalf.
All persons under 18 years of age must have a Waiver of Liability signed on their behalf by a parent or guardian before attending a Studio Pilates International class. Once the parent or guardian has signed the waiver, persons under 18 years of age may attend Studio Pilates International classes.
Please note: terms and conditions of this release form and waiver of liability are subject to change without notice.