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Pure Barre New Client Waiver

 

Liability Waiver: You workout at your own risk!

 

This release and indemnity agreement is made by the undersigned adult (Participant) to release and indemnify HND Holdings Co. dba Pure Barre, and all of its respective members, employees, heirs, successors, agents, contractors, as set forth below.

Participant is voluntarily participating in the activity with full knowledge, understanding, and appreciation of the risks inherent in any physical exercise and expressly assumes all risks of injury and even death, which could occur by reason of participants participation.

Participant releases HND Holdings Co. dba Pure Barre from any liability and agrees not to sue Pure Barre for any cause of action for bodily injury, property damage, or death occurring to participant as a result of participating in this exercise program.

Participant hereby assumes full responsibility for risks of bodily injury or death to participant due to the ordinary negligence of Pure Barre. Participant agrees to indemnify, defend and hold harmless at Participants sole cost HND Holdings Co.dba Pure Barre from any and all claims arising out of participants participation in the exercise program.

Please don't steal our technique

By signing below you are agreeing not to teach or reproduce in any way any of the exercises, movements, class formats, choreography, or music compilations from this studio. Any violation of this contract will be enforced to the maximum extent permitted by law, which may include but is not limited to injunctive relief, punitive damages and attorneys fees.

We may post your pics to Instagram, our website, or other social media

By signing below you are agreeing to allow Pure Barre to take your picture and use your picture on its social media page.  In the event you don't want Pure Barre to use your picture, please inform Pure Barre and it will remove any picture of you. 

Participant has read and voluntarily signs this release and indemnity agreement.

I Agree

May 16, 2024

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

How did you hear about us?

Do you have any injuries? *
Are you currently an exercise instructor, owner of a fitness studio, or employee at a fitness studio?*

If yes, which studio?
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

How did you hear about us?

Do you have any injuries? *
Are you currently an exercise instructor, owner of a fitness studio, or employee at a fitness studio?*

If yes, which studio?
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

How did you hear about us?

Do you have any injuries? *
Are you currently an exercise instructor, owner of a fitness studio, or employee at a fitness studio?*

If yes, which studio?
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

How did you hear about us?

Do you have any injuries? *
Are you currently an exercise instructor, owner of a fitness studio, or employee at a fitness studio?*

If yes, which studio?
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

How did you hear about us?

Do you have any injuries? *
Are you currently an exercise instructor, owner of a fitness studio, or employee at a fitness studio?*

If yes, which studio?
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

How did you hear about us?

Do you have any injuries? *
Are you currently an exercise instructor, owner of a fitness studio, or employee at a fitness studio?*

If yes, which studio?
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

How did you hear about us?

Do you have any injuries? *
Are you currently an exercise instructor, owner of a fitness studio, or employee at a fitness studio?*

If yes, which studio?
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

How did you hear about us?

Do you have any injuries? *
Are you currently an exercise instructor, owner of a fitness studio, or employee at a fitness studio?*

If yes, which studio?
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

How did you hear about us?

Do you have any injuries? *
Are you currently an exercise instructor, owner of a fitness studio, or employee at a fitness studio?*

If yes, which studio?
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

How did you hear about us?

Do you have any injuries? *
Are you currently an exercise instructor, owner of a fitness studio, or employee at a fitness studio?*

If yes, which studio?
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, specials, and discounts by e-mail.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

How did you hear about us?

Do you have any injuries? *
Are you currently an exercise instructor, owner of a fitness studio, or employee at a fitness studio?*

If yes, which studio?
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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