Parental Waiver for Minor

Please print, fill out and bring to your first session.

SUZANNE KENDALL-JOHNSON PILATES AND THE PREMISES SHE CONDUCTS PILATES BUSINESS

I, THE PARENT OR LEGAL GUARDIAN OF _______________________________, A MINOR, CONSENT TO HIS/HER PARTICIPATION IN PILATES AND ANY OTHER PHYSICAL ACTIVITIES WITH SUZANNE KENDALL-JOHNSON.

I CONSENT TO THE PARTICIPATION OF MY CHILD/WARD WITH A FULL UNDERSTANDING THAT THERE IS A RISK OF INJURY FROM ALL PHYSICAL ACTIVITY, INCLUDING PILATES. UNDERSTANDING THAT, I ALSO UNDERSTAND THAT MEDICAL EXPENSES, TIME LOST FROM SCHOOL OR WORK AND OTHER DAMAGES AND LOSSES, INCLUDING PERMANENT IMPAIRMENT OR EVEN DEATH CAN OCCUR,

IN CONSIDERATION FOR ALLOWING MY CHILD/WARD TO PARTICIPATE IN PILATES HELD WITH SUZANNE JOHNSON, I HERBY RELEASE, ACQUIT, FROM ANY AND ALL CLAIMS, SUITS, ACTIONS, AND CAUSES OF ACTION THAT I OR MY CHILD/WARD MAY HEREAFTER ACQUIRE AS A RESULTS OF ANY ACCIDENT, UNJURY, DAMAGE OR LOSS THAT MY CHILD/WARD INCURS OR SUSTAINS DURING HIS/HER PARTICIPATION IN PILATES WITH SUZANNE KENDALL- JOHNSON. FURTHERMORE, I AGREE TO INDEMNIFY, DEFEND AND HOLD HARMLESS SUZANNE JOHNSON FROM AND AGAINST ALL CLAIMS, SUITS, ACTIONS AND CAUSES OF ACTION THAT MAY BE BROUGHT BY ME, MY CHILD/WARD OR ANY OTHER PERSON ON BEHALF OF MY CHILD/WARD AS A RESULT OF ANY ACCIDENT, INJURY, DAMAGE OR LOSS THAT MY CHILD/WARD INCURS OR SUSTAINS DURING HIS/HER PARTICIPATION IN PILATES WITH SUZANNE KENDALL- JOHNSON.

I HAVE READ THIS PARENTAL CONSENT, RELEASE FROM LIABILITY AND INDEMNITY AGREEMENT. I UNDERSTAND ITS TERMS. I UNDERSTAND THAT I MAY BE GIVING UP SUBSTANTIAL RIGHTS FOR MYSELF AND /OR MY CHILD/WARN, AND I SIGN IT FREELY AND VOLUNTARILY.


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Guardian’s printed name              Guardian’s signature


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