Waiver Form | EnCore Pilates

Please take a moment to review our Waiver Form

This form is an important legal document. It explains the risks you are assuming by beginning an exercise program. It is critical that you read and understand it completely. After you have done so, please print your name legibly and sign in the spaces provided at the bottom.

waiver and covenant not to sue

have volunteered to participate in a program of physical exercise under the direction of EnCore Pilates, which will include, but may not be limited to, weight and/or resistance training. In consideration of EnCore Pilates’ agreement to instruct, assist, and train me, I do here and forever release and discharge and hereby hold harmless, EnCore Pilates, and their respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program (and including their negligent and/or omissions ) any injuries resulting there from.

assumption of risk

recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of certain unusual physical changes during exercise does exist. These changes include abnormal blood pressure, fainting, disorders in heartbeat, heart attack, and in rare instance, death.

I understand that physical contact is an integral part of this exercise program and is done in a therapeutic manner.

I understand that as a result of my participation in an exercise program, I could suffer an injury or physical disorder that could result in my becoming partially or totally disabled and incapable of performing any gainful employment or having a normal social life.

I recognize that all participants, prior to involvement in any exercise program, should obtain an examination and clearance to participate by a physician.

If I,

have chosen not to obtain a physician’s permission prior to beginning this exercise program with EnCore Pilates, I hereby agree that I am doing so at my own risk. In any event, I acknowledge and agree that I assume the risks associated with any and all activities and/or exercise in which I participate. I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from this program. I understand that results are individual and may vary.

Signature of Patient/Parent/Guardian

Print Name

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