Class Participation Waiver URLThis field is for validation purposes and should be left unchanged.Participants Name(Required) First Last Phone(Required)Email Participants Date of Birth Month Day Year Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Class Name or Type(Required)Class Date(s)(Required)Emergency Contact(Required)Emergency Contact Phone Number(Required)Does the participant have any medical conditions or allergies we should be aware of?Terms and Conditions(Required)Please read the following waiver and provide your consent to participate: I acknowledge that participation in this in-person class may involve physical activity and/or other inherent risks. I confirm that I am voluntarily participating and accept all responsibility for any injury or incident that may occur. I agree to follow all safety instructions provided by the organizers and release the class organizers and facility from any liability related to my participation. I accept the terms and conditions of this agreement and agree to comply with all related rules and policies. I understand that I may withdraw my consent at any time by contacting the organization, recognizing that doing so may affect my ability to continue with the related service or activity. I confirm that I have read and understood the terms outlined above.Date Month Day Year Signature(Required)
