New Participant Waver Form

Participant Waiver Form

Name(Required)

First Last

Email(Required)

Cell Phone(Required)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Date of Birth

Leader Name(Required)

Leader Class City & State(Required)

Emergency Contact Information

Emergency Contact Name(Required)

First Last

Emergency Contact Phone(Required)

Emergency Contact Relationship(Required)

Agreement of Release and Waiver of Liability

I (the participant name entered above) voluntarily agree to participate in SOULCORE classes. I recognize that this work involves physical activity and movement, which may carry some natural risks. I am responsible for my own experience and my own safety. I also understand that I am responsible for continuing to monitor my physical limits. I represent and warrant that I have no medical conditions that would endanger me in any way or prevent my participation in the classes.

I, my heirs, and legal representative forever release, waive, discharge and covenant not to sue SoulCore, LLC, landlord, agents or any associates for any claim I may have for injury, or damages that I may sustain as a result of my participation SoulCore classes.

I have read the release and waiver of liability and fully understand its consent. I voluntarily agree to the terms and conditions stated above.

By entering my name below, I agree to the terms outlined above:(Required)

If Participant is Under 18

As legal guardian of (participant name entered above), I consent to the above listed terms and conditions.

Please enter the full name of the legal guardian. By entering my name below, I agree to the terms above.

Participant Waiver Form

Emergency Contact Information

Agreement of Release and Waiver of Liability

If Participant is Under 18

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