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La Luna Wellness Studio Liability Waiver & Release Agreement

I understand that every class, event or lesson held with La Luna Wellness Studio includes physical movements as well as an opportunity for relaxation, stress re-education, relief of muscular tension as well as strength and flexibility to the overall body. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. ​If I experience any pain or discomfort, I will listen to my body, discontinue the activity, and ask for support from the instructor. I will continue to breathe smoothly.​ ​I assume full responsibility for any and all damages or injury, which may incur through participation.

The fitness and wellness classes, events and lessons held with La Luna Wellness Studio are not substitutes for medical attention, examination, diagnosis or treatment. The fitness and wellness classes, events and lessons held with La Luna Wellness Studio are not recommended and are not safe under certain medical conditions. By signing, I affirm that a licensed physician has verified my good health and physical condition to participate in such fitness and wellness programs. In addition, I will make the instructor aware of any medical conditions or physical limitations before class. If I am pregnant, become pregnant or I am postnatal or post-surgical, my signature verifies that I have my physician’s approval to participate. I also affirm that I alone am responsible to decide whether to participate in any classes, events or lessons at my own risk. I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against La Luna Wellness Studio and it’s instructors.

Dated: September 20, 2020 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Age

Photo & Video Release

I hereby authorize La Luna Wellness Studio to utilize photographs, videos and recordings ( collectively the "images") of myself either captured by La Luna Wellness Studio or provided by me in any promotional material, including but not limited to social media websites and outlets, brochures, promotional videos and clips, and posters. I hereby release and discharge La Luna Wellness Studio of and from any and all claims, demands causes of action, liability, damages, and losses of any kind and nature that arise directly or indirectly from the use of my name and/ or the images. The images are to be used exclusively by La Luna Wellness Studio and may not be sold, licensed or otherwise transferred by La Luna Wellness Studio. ​All videos and photos taken in class will only be done by La Luna Wellness Studio teachers/ or staff.​ It is solely up to the individual teaching the class to whether they will allow any additional videos and/ or to be taken. If in the event La Luna Wellness Studio will permit you to take your own video and or photo you will be given clear verbal permission to do so.

I have read and fully understand and agree to the above terms and conditions of this Liability Waiver and Release Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law. 

Photo & Video Release*
First Participant's Signature*
Second Participant's Name

First Name*

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

Age

Photo & Video Release

I hereby authorize La Luna Wellness Studio to utilize photographs, videos and recordings ( collectively the "images") of myself either captured by La Luna Wellness Studio or provided by me in any promotional material, including but not limited to social media websites and outlets, brochures, promotional videos and clips, and posters. I hereby release and discharge La Luna Wellness Studio of and from any and all claims, demands causes of action, liability, damages, and losses of any kind and nature that arise directly or indirectly from the use of my name and/ or the images. The images are to be used exclusively by La Luna Wellness Studio and may not be sold, licensed or otherwise transferred by La Luna Wellness Studio. ​All videos and photos taken in class will only be done by La Luna Wellness Studio teachers/ or staff.​ It is solely up to the individual teaching the class to whether they will allow any additional videos and/ or to be taken. If in the event La Luna Wellness Studio will permit you to take your own video and or photo you will be given clear verbal permission to do so.

I have read and fully understand and agree to the above terms and conditions of this Liability Waiver and Release Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law. 

Photo & Video Release*
Third Participant's Name

First Name*

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

Age

Photo & Video Release

I hereby authorize La Luna Wellness Studio to utilize photographs, videos and recordings ( collectively the "images") of myself either captured by La Luna Wellness Studio or provided by me in any promotional material, including but not limited to social media websites and outlets, brochures, promotional videos and clips, and posters. I hereby release and discharge La Luna Wellness Studio of and from any and all claims, demands causes of action, liability, damages, and losses of any kind and nature that arise directly or indirectly from the use of my name and/ or the images. The images are to be used exclusively by La Luna Wellness Studio and may not be sold, licensed or otherwise transferred by La Luna Wellness Studio. ​All videos and photos taken in class will only be done by La Luna Wellness Studio teachers/ or staff.​ It is solely up to the individual teaching the class to whether they will allow any additional videos and/ or to be taken. If in the event La Luna Wellness Studio will permit you to take your own video and or photo you will be given clear verbal permission to do so.

I have read and fully understand and agree to the above terms and conditions of this Liability Waiver and Release Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law. 

Photo & Video Release*
Fourth Participant's Name

First Name*

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

Age

Photo & Video Release

I hereby authorize La Luna Wellness Studio to utilize photographs, videos and recordings ( collectively the "images") of myself either captured by La Luna Wellness Studio or provided by me in any promotional material, including but not limited to social media websites and outlets, brochures, promotional videos and clips, and posters. I hereby release and discharge La Luna Wellness Studio of and from any and all claims, demands causes of action, liability, damages, and losses of any kind and nature that arise directly or indirectly from the use of my name and/ or the images. The images are to be used exclusively by La Luna Wellness Studio and may not be sold, licensed or otherwise transferred by La Luna Wellness Studio. ​All videos and photos taken in class will only be done by La Luna Wellness Studio teachers/ or staff.​ It is solely up to the individual teaching the class to whether they will allow any additional videos and/ or to be taken. If in the event La Luna Wellness Studio will permit you to take your own video and or photo you will be given clear verbal permission to do so.

I have read and fully understand and agree to the above terms and conditions of this Liability Waiver and Release Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law. 

Photo & Video Release*
Fifth Participant's Name

First Name*

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

Age

Photo & Video Release

I hereby authorize La Luna Wellness Studio to utilize photographs, videos and recordings ( collectively the "images") of myself either captured by La Luna Wellness Studio or provided by me in any promotional material, including but not limited to social media websites and outlets, brochures, promotional videos and clips, and posters. I hereby release and discharge La Luna Wellness Studio of and from any and all claims, demands causes of action, liability, damages, and losses of any kind and nature that arise directly or indirectly from the use of my name and/ or the images. The images are to be used exclusively by La Luna Wellness Studio and may not be sold, licensed or otherwise transferred by La Luna Wellness Studio. ​All videos and photos taken in class will only be done by La Luna Wellness Studio teachers/ or staff.​ It is solely up to the individual teaching the class to whether they will allow any additional videos and/ or to be taken. If in the event La Luna Wellness Studio will permit you to take your own video and or photo you will be given clear verbal permission to do so.

I have read and fully understand and agree to the above terms and conditions of this Liability Waiver and Release Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law. 

Photo & Video Release*
Sixth Participant's Name

First Name*

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

Age

Photo & Video Release

I hereby authorize La Luna Wellness Studio to utilize photographs, videos and recordings ( collectively the "images") of myself either captured by La Luna Wellness Studio or provided by me in any promotional material, including but not limited to social media websites and outlets, brochures, promotional videos and clips, and posters. I hereby release and discharge La Luna Wellness Studio of and from any and all claims, demands causes of action, liability, damages, and losses of any kind and nature that arise directly or indirectly from the use of my name and/ or the images. The images are to be used exclusively by La Luna Wellness Studio and may not be sold, licensed or otherwise transferred by La Luna Wellness Studio. ​All videos and photos taken in class will only be done by La Luna Wellness Studio teachers/ or staff.​ It is solely up to the individual teaching the class to whether they will allow any additional videos and/ or to be taken. If in the event La Luna Wellness Studio will permit you to take your own video and or photo you will be given clear verbal permission to do so.

I have read and fully understand and agree to the above terms and conditions of this Liability Waiver and Release Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law. 

Photo & Video Release*
Seventh Participant's Name

First Name*

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

Age

Photo & Video Release

I hereby authorize La Luna Wellness Studio to utilize photographs, videos and recordings ( collectively the "images") of myself either captured by La Luna Wellness Studio or provided by me in any promotional material, including but not limited to social media websites and outlets, brochures, promotional videos and clips, and posters. I hereby release and discharge La Luna Wellness Studio of and from any and all claims, demands causes of action, liability, damages, and losses of any kind and nature that arise directly or indirectly from the use of my name and/ or the images. The images are to be used exclusively by La Luna Wellness Studio and may not be sold, licensed or otherwise transferred by La Luna Wellness Studio. ​All videos and photos taken in class will only be done by La Luna Wellness Studio teachers/ or staff.​ It is solely up to the individual teaching the class to whether they will allow any additional videos and/ or to be taken. If in the event La Luna Wellness Studio will permit you to take your own video and or photo you will be given clear verbal permission to do so.

I have read and fully understand and agree to the above terms and conditions of this Liability Waiver and Release Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law. 

Photo & Video Release*
Eighth Participant's Name

First Name*

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

Age

Photo & Video Release

I hereby authorize La Luna Wellness Studio to utilize photographs, videos and recordings ( collectively the "images") of myself either captured by La Luna Wellness Studio or provided by me in any promotional material, including but not limited to social media websites and outlets, brochures, promotional videos and clips, and posters. I hereby release and discharge La Luna Wellness Studio of and from any and all claims, demands causes of action, liability, damages, and losses of any kind and nature that arise directly or indirectly from the use of my name and/ or the images. The images are to be used exclusively by La Luna Wellness Studio and may not be sold, licensed or otherwise transferred by La Luna Wellness Studio. ​All videos and photos taken in class will only be done by La Luna Wellness Studio teachers/ or staff.​ It is solely up to the individual teaching the class to whether they will allow any additional videos and/ or to be taken. If in the event La Luna Wellness Studio will permit you to take your own video and or photo you will be given clear verbal permission to do so.

I have read and fully understand and agree to the above terms and conditions of this Liability Waiver and Release Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law. 

Photo & Video Release*
Ninth Participant's Name

First Name*

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

Age

Photo & Video Release

I hereby authorize La Luna Wellness Studio to utilize photographs, videos and recordings ( collectively the "images") of myself either captured by La Luna Wellness Studio or provided by me in any promotional material, including but not limited to social media websites and outlets, brochures, promotional videos and clips, and posters. I hereby release and discharge La Luna Wellness Studio of and from any and all claims, demands causes of action, liability, damages, and losses of any kind and nature that arise directly or indirectly from the use of my name and/ or the images. The images are to be used exclusively by La Luna Wellness Studio and may not be sold, licensed or otherwise transferred by La Luna Wellness Studio. ​All videos and photos taken in class will only be done by La Luna Wellness Studio teachers/ or staff.​ It is solely up to the individual teaching the class to whether they will allow any additional videos and/ or to be taken. If in the event La Luna Wellness Studio will permit you to take your own video and or photo you will be given clear verbal permission to do so.

I have read and fully understand and agree to the above terms and conditions of this Liability Waiver and Release Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law. 

Photo & Video Release*
Tenth Participant's Name

First Name*

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

Age

Photo & Video Release

I hereby authorize La Luna Wellness Studio to utilize photographs, videos and recordings ( collectively the "images") of myself either captured by La Luna Wellness Studio or provided by me in any promotional material, including but not limited to social media websites and outlets, brochures, promotional videos and clips, and posters. I hereby release and discharge La Luna Wellness Studio of and from any and all claims, demands causes of action, liability, damages, and losses of any kind and nature that arise directly or indirectly from the use of my name and/ or the images. The images are to be used exclusively by La Luna Wellness Studio and may not be sold, licensed or otherwise transferred by La Luna Wellness Studio. ​All videos and photos taken in class will only be done by La Luna Wellness Studio teachers/ or staff.​ It is solely up to the individual teaching the class to whether they will allow any additional videos and/ or to be taken. If in the event La Luna Wellness Studio will permit you to take your own video and or photo you will be given clear verbal permission to do so.

I have read and fully understand and agree to the above terms and conditions of this Liability Waiver and Release Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law. 

Photo & Video Release*
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, and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Age

Photo & Video Release

I hereby authorize La Luna Wellness Studio to utilize photographs, videos and recordings ( collectively the "images") of myself either captured by La Luna Wellness Studio or provided by me in any promotional material, including but not limited to social media websites and outlets, brochures, promotional videos and clips, and posters. I hereby release and discharge La Luna Wellness Studio of and from any and all claims, demands causes of action, liability, damages, and losses of any kind and nature that arise directly or indirectly from the use of my name and/ or the images. The images are to be used exclusively by La Luna Wellness Studio and may not be sold, licensed or otherwise transferred by La Luna Wellness Studio. ​All videos and photos taken in class will only be done by La Luna Wellness Studio teachers/ or staff.​ It is solely up to the individual teaching the class to whether they will allow any additional videos and/ or to be taken. If in the event La Luna Wellness Studio will permit you to take your own video and or photo you will be given clear verbal permission to do so.

I have read and fully understand and agree to the above terms and conditions of this Liability Waiver and Release Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law. 

Photo & Video Release*
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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