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Waiver, Release, and Assumption of Risk Form
For Core Sculpt, LLC dba SCULPT50  

ASSUMPTION OF RISK: I acknowledge that my presence at, and participation in physical exercise at Core Sculpt, LLC d/b/a Sculpt50 (hereinafter referred to as Sculpt50), and the entry to and use of the equipment, studio and/or services at Sculpt50, naturally involves the risk of injury or death to me, whether I, Sculpt50, or someone else causes it. I further acknowledge that specific risks include injuries or death resulting from overexertion, physical adjustment, improper or negligent use of equipment, failure to follow trainer instructions, or injuries resulting from participation in an inappropriate level of physical exercise. As such, I understand and voluntarily accept these risks.  


COVID-19: COVID-19 has been recognized globally as a contagious respiratory virus, posing an imminent health threat. I understand that, even despite its best efforts, Sculpt50 cannot guarantee that I will not become infected with COVID-19 at Sculpt50. Furthermore, I understand that entry to and use of the equipment studio, and/or services at Sculpt50 could increase my risk of contracting COVID-19. I further acknowledge the contagious nature of COVID-19, and I knowingly and voluntarily accept all risk that I may be exposed to or infected by COVID-19 at or in Sculpt50, and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. HEALTH WARRANTY: I represent that I am in good physical and mental health, at least 18 years of age, have the necessary current medical approval to engage in physical exercise, and have no disability, impairment, injury, disease or ailment preventing me from engaging in physical exercise, Sculpt50 instructional classes which would cause risk of injury or adverse health consequences as a result of engaging in physical exercise. I acknowledge that Sculpt50, is relying on this representation and I understand that Sculpt50, does not and will not investigate or certify my health or my fitness to participate in physical exercise, Pilates based instructional classes in the studio.


RELEASE AND WAIVER OF LIABILITY: I, individually, and on behalf of my spouse, partner, heirs, children, unborn children, next of kin, distributees, guardians, legal representatives, and assigns, agree not to sue and hereby agree to defend, indemnify, release and hold harmless Sculpt50, and its shareholders, officers, directors, employees, staff, volunteers, members, contractors, representatives, agents, successors, assigns, and affiliated entities and the owner/lessor of Sculpt50 and its studio (collectively, the "Releasees") from all actions, claims, demands, suits, losses, liabilities, charges, expenses (including, without limitation, attorneys' fees), and costs of any nature whatsoever which may arise out of, relate to, or result from, any death or injury, including, without limitation, personal, bodily or mental injury, illness (including, but not limited to COVID-19), economic loss or any damage to me or my spouse or partner, guest, unborn child, or relatives resulting from my participation in physical exercise, Pilates based instructional classes at Sculpt50, entry to, or use of, the studio(s), equipment or services at Sculpt50, the negligence of Sculpt50, anyone on Sculpt50’s behalf or anyone using Sculpt50, equipment, facilities, studio(s) or services, except such as may arise out of the gross negligence or willful misconduct of the Releasees. This release and waiver of liability (this "Release") is intended to be a complete release of any responsibility for death, illness, personal injuries and/or property loss/damage sustained by me while at Sculpt50, whether using exercise equipment, participating in active or passive exercise, or not. I understand that this Release is intended to be as broad and inclusive as is permitted by the laws of the State of California and that if any portion of this Release is held invalid, I agree that the balance of this Release should continue in full force and effect. I further waive and release Releasees from, and agree to indemnify and hold harmless the Releasees and all of their respective staff, coaches, instructors, officers, members, employees, volunteers, independent contractors, agents, representatives, heirs, executors, successors or assigns from and against any liability for the injury or death of any person(s) and damage to property or loss resulting from, or in any way related to my negligent or intentional act or omission while participating in physical exercise and activities or my entry to Sculpt50 facilities and/or studio. I have carefully read this waiver and release agreement and understand the terms set forth herein and that this is a legally binding document that affects my rights and remedies. 


Social Media and Publications Agreement

I do hereby grant the studio permission to use my likeness in photograph or video in any and all of its publications, including website entries and social media, without compensation or any other consideration. I understand and agree that these materials will become the property of Sculpt50 and will not be returned. I hereby irrevocably authorize Sculpt50 edit, alter, copy, exhibit, publish or distribute images of me for purposes of publicizing Sculpt50 programs or for any other 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 rights to royalties or other compensation arising or related to the use of the photograph or video.



Today's Date: June 6, 2025

First Client Name
First Name*
Last Name*
Phone*
First Client Age Acknowledgment*
First Client Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Client Signature*
Second Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Third Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Fourth Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Fifth Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Sixth Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Seventh Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Eighth Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Ninth Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Tenth Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Client 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:*
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*
Check to receive information, news, 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*
Date of Birth
I certify that I am 18 years of age or older
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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