** PRE-EXERCISE HEALTH SCREEN **

LIABILITY WAIVER: By proceeding with payment and my booking I understand that I have registered for the class Breezygirl Step group fitness step class. I recognize that this exercise class may involve strenuous physical activity including, but not limited to, muscle strength, endurance, cardiovascular conditioning, and other various fitness activities. I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition which would prevent or otherwise limit my full participation in this physical class. In addition, I am fully aware of the risks and hazards connected with any exercise or fitness activity involves a risk of injury, as well as abnormal changes in blood pressure, fainting, and a remote risk of heart attack, stroke, other serious disability, or death. I am accepting such risks and volunteering to participate with full understanding of the dangers involved. I hereby elect to voluntarily participate in this class knowing that the associated physical activity may be hazardous to me. and/or my property. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OR LOSS, OR PERSONAL INJURY, INCLUDING DEATH, that may be sustained by me, as a result of participation in this CLASS. I hereby release, waive, discharge, and covenant not to sue Breezygirl Step, today’s host and/or any of its, servants, agents, consultants, volunteers, and/or employees from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury (including, but not limited to, death) that may be sustained by me, while participating in this class, or while on or upon the premises where the event is being conducted including, but not limited to, any claims arising under negligence. It is my expressed intent that this waiver and release shall bind any and all members of my family including, but not limited to, my spouse, if I am alive, and my heirs, assigns, and personal representatives, if I am deceased. It is also my expressed intent that this waiver and release shall also be deemed a full release, waiver, discharge, and covenant not to sue insofar as my aforementioned family members, heirs, assigns, and personal representatives are concerned. In signing this waiver and release, I acknowledge and represent that I have read and understand the foregoing and hereby sign it voluntarily as my own free act and deed; no oral representations, statements or inducements, apart from the foregoing written agreements have been made; and I hereby execute this waiver and release for valuable consideration, intending to be bound by the same.   I grant to Breezygirl Step the right to take photographs and/or video footage of me in connection with the above-identified event. I authorise Breezygirl Step, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Breezygirl Step may use such photographs and/or video of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, marketing and Web content. I grant Breezygirl Step to contact me via email, letter, social media, phone call or SMS to advise of any future classes or events that they hold. By proceeding with my booking, I confirm and agree to all the above.