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WELCOME TO GOD LEADING OUR WELLNESS (GLOW) !

We are a women's fitness ministry! Our Mission is to help women feel loved and confident in the image God created them through faith inspired fitness classes and wellness encouragement.  

WE ARE SO GLAD YOU"RE HERE!

BEFORE PARTICIPATING IN OUR CLASSES YOU MUST COMPLETE THE WAIVER FORM.

I, an individual, state my desire to participate in certain activities being offered by or through God Leading Our Wellness, Inc. DBA GLOW, the corporate structure, its officers, directors, employees, agents, contractors, and volunteers (collectively referred to as “GLOW") and in consideration for being allowed to participate state and agree as follows:

I warrant that I possess all the rights, powers, and privileges on behalf of myself or as a parent or legal guardian necessary to execute this document with binding legal effect.

 I certify and affirm that I have been completely and thoroughly informed that by attending the activities of God Leading Our Wellness (GLOW), I will participate in certain activities which carry with them a degree of risk and danger.

 Examples of risky and dangerous activities include, but are not limited to:

1.   physical activities, both indoors and outdoors, (dancing, cardio fitness, kickboxing, walking, strength training etc.…)

2.   sports, both informal and organized;

3.   use of recreational equipment, (use of hand weights, drumsticks, resistance bands, Pilates balls etc.…)

4.   field trips, (any outing organized by God Leading Our Wellness (GLOW)

5.   travel by automobile;

6.   Special fitness and wellness events hosted or organized by God Leading Our Wellness (GLOW)

 I acknowledge and understand that God Leading Our Wellness (GLOW) may offer other activities not listed above that present similar risks or dangers to me. I understand that these activities, listed and not listed, may be undertaken on or off Church property. I understand that injuries resulting from participation in these activities, listed and not listed, could range from minor aches, bruises and cuts, illness or disease, physical or mental damage and to serious, permanent and disabling injuries, and even in death.

 I consent to my participation in these activities. I acknowledge and understand that this AUTHORIZATION, CONSENT AND RELEASE has the same force and effect regardless of whether the activities engaged in are free or if a fee is charged.      


Further, I personally assume, on my behalf, all risk in connection with said activities for any harm, injury or damages that may befall me as a result of participation in the activities, whether foreseen or unforeseen, and I still wish to proceed with the activities. As a matter of fact, I am familiar with the nature, degree, and type of risks associated with these activities and do not need them explained to me.

In consideration of me being allowed to participate in these activities and to use God Leading Our Wellness(GLOW)’s equipment, facilities, staff or volunteers or hired contractors, I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless the God Leading Our Wellness(GLOW), including the corporate structure, officers, directors, employees, agents, contractors, and volunteers, from any and all claims, demands, or causes of action, which are in any way connected with my participation in these activities or use of God Leading Our Wellness (GLOW) or site event's equipment, facilities or personnel, an individual.


IN CASES OF EMERGENCY, I further consent to the examination or treatment by a physician duly licensed to practice medicine in the jurisdiction where the emergency occurs or any health care professional duly licensed to provide health care services in the state where the emergency occurs for medical care and services deemed necessary by God Leading Our Wellness (GLOW), its agents, servants, and employees.


I understand and agree that the God Leading Our Wellness (GLOW) is not under a legal duty or requirement to render aid or medical treatment but will use its best judgment as to when to render aid or summon medical care.


I give permission to the doctor or health care professional to provide any and all medical care they deem, in their professional opinion, to be necessary to maintain the health, safety, and life of me.  I agree to pay for any and all medical expenses incurred as a result of the use of this consent.


I understand that it is my obligation to inform an authorized representative of God Leading Our Wellness (GLOW) of any and all health considerations or medical conditions that would restrict my participation in any and all activities while engaged in the activities. I shall not participate in the activities if I am/is not presently healthy or alert enough to, in my judgment, do so.


I hereby affirm myself to be physically sound and suffering from no condition, ailment, impairment, disease, or any other illness that would prevent my participation in God Leading Our Wellness (GLOW) activities declare that I have disclosed any and all medical history to God Leading Our Wellness (GLOW) and/or their affiliates relevant to participation.


MEDIA RELEASE READ CAREFULLY - THIS AFFECTS YOUR LEGAL RIGHTS, For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I hereby consent and agree to the following: I grant to God Leading Our Wellness, Inc. (GLOW), a Florida nonprofit corporation, and to its board members, employees, directors, officers, licensees, successors and assigns (each individually and collectively as "GLOW"), the irrevocable, royalty-free, perpetual, unlimited worldwide right to use, distribute, publish, exhibit, digitize, broadcast, display, modify and create derivative works of, reproduce or otherwise exploit my name, picture, likeness and voice including any video footage of the same) (collectively "Media"), for any purpose (except in a defamatory manner) including, without limitation, rights to use for educational, advertising, non-commercial or commercial purposes in any manner or media format whatsoever, and including, without limitation, publication of the Media on the internet, radio, television and in printed form. I agree that I retain no interest in or ownership of any of the Media. I understand that I do not have any right to preview or approve or reject Media use, I shall not be compensated for Media use, and I waive any claim arising from Media use (including, without limitation, waiver of any claim based upon invasion of privacy, libel or defamation) regardless of whether the Media has been altered, blurred, or otherwise distorted. I hereby release and agree to hold harmless God Leading Our Wellness (GLOW) from any claim for injury, loss, damages or other liability which I may have and which may arise from the use of any of the Media.

I hereby grant God Leading Our Wellness (GLOW) permission to use my likeness in a photograph in any and all its Publications, including but not limited to all of God Leading Our Wellness (GLOW) printed and digital publications. I understand and agree that any photograph using my likeness will become property of God Leading Our Wellness (GLOW) and will not be returned. I acknowledge that since my participation with God Leading Our Wellness (GLOW) is voluntary; I will NOT receive financial compensation. I hereby irrevocably authorize God Leading Our Wellness (GLOW) to edit, copy, exhibit publish or distribute this photo for purposes of publicizing God Leading Our Wellness (GLOW) programs, or for any other related, lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. I hereby hold harmless and release and forever discharge God Leading Our Wellness (GLOW) from all claims, demands, and causes of action to which I, my heirs, representatives, executors, administrators, or any other person's action on my behalf or on behalf of my estate have or may have by reason of this authorization. BY SIGNING BELOW, I AFFIRM I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING BELOW, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.


RELEASE OF LIABILITY; READ CAREFULLY- THIS AFFECTS YOUR LEGAL RIGHTS

In exchange for participation in the activity of Cardio, Dance, Strength Training, Resistance Bands, Drumsticks, Belly Dance, Deep Stretch, Praise Movement or Organized Walks arranged or organized by God Leading Our Wellness (GLOW), use of the property, facilities and services of God Leading Our Wellness (GLOW), and I agree for myself and (if applicable) for the members of my family, to the following:

1.        AGREEMENT TO FOLLOW DIRECTIONS. I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by God Leading Our Wellness (GLOW) or the employees, representatives or agents of God Leading Our Wellness (GLOW).

2.        ASSUMPTION OF THE RISKS AND RELEASE. I recognize that there are certain inherent risks associated with the above described activity and I assume full responsibility for personal injury to myself and (if applicable) any family members, and further release and discharge God Leading Our Wellness (GLOW) for injury, loss or damage arising out of my or my family's use of or presence upon the facilities of God Leading Our Wellness (GLOW), whether caused by the fault of myself, my family, God Leading Our Wellness (GLOW) or other third parties.

3.        INDEMNIFICATION. I agree to indemnify and defend God Leading Our Wellness (GLOW) against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my or my family's use of or presence upon the facilities of God Leading Our Wellness (GLOW).

4.        FEES. I agree to pay for all damages to the facilities of God Leading Our Wellness (GLOW) caused by any negligent, reckless, or willful actions by me or my family.

5.        APPLICABLE LAW. Any legal or equitable claim that may arise from participation in the above shall be resolved under Florida law.

6.        NO DURESS. I agree and acknowledge that I am under no pressure or duress to sign this Agreement and that I have been given a reasonable opportunity to review it before signing. I further agree and acknowledge that I am free to have my own legal counsel review this Agreement if I so desire. I further agree and acknowledge that God Leading Our Wellness (GLOW) has offered to refund any fees I have paid to use its facilities if I choose not to sign this Agreement.

7.        ARM'S LENGTH AGREEMENT. This Agreement and each of its terms are the product of an arm's length negotiation between the Parties. In the event any ambiguity is found to exist in the interpretation of this Agreement, or any of its provisions, the Parties, and each of them, explicitly reject the application of any legal or equitable rule of interpretation which would lead to a construction either "for" or "against" a particular party based upon their status as the drafter of a specific term, language, or provision giving rise to such ambiguity.

8.        ENFORCEABILITY. The invalidity or unenforceability of any provision of this Agreement, whether standing alone or as applied to a particular occurrence or circumstance, shall not affect the validity or enforceability of any other provision of this Agreement or of any other applications of such provision, as the case may be, and such invalid or unenforceable provision shall be deemed not to be a part of this Agreement. I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.



First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Do You Have Any Medical Restrictions?*
No
Yes

If yes, what are your restrictions?

Church Home?
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Do You Have Any Medical Restrictions?*
No
Yes

If yes, what are your restrictions?

Church Home?
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Do You Have Any Medical Restrictions?*
No
Yes

If yes, what are your restrictions?

Church Home?
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Do You Have Any Medical Restrictions?*
No
Yes

If yes, what are your restrictions?

Church Home?
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Do You Have Any Medical Restrictions?*
No
Yes

If yes, what are your restrictions?

Church Home?
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Do You Have Any Medical Restrictions?*
No
Yes

If yes, what are your restrictions?

Church Home?
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Do You Have Any Medical Restrictions?*
No
Yes

If yes, what are your restrictions?

Church Home?
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Do You Have Any Medical Restrictions?*
No
Yes

If yes, what are your restrictions?

Church Home?
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Do You Have Any Medical Restrictions?*
No
Yes

If yes, what are your restrictions?

Church Home?
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Do You Have Any Medical Restrictions?*
No
Yes

If yes, what are your restrictions?

Church Home?
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
Parent or Guardian's Email Address

Email*

Confirm Email*
By completing this form you may receive future information regarding our organization.
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Do You Have Any Medical Restrictions?*
No
Yes

If yes, what are your restrictions?

Church Home?
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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