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Please fill out the form below to sign up for the first Zumba class on October 1st at 10:30 AM.

Liability Waiver: 

This agreement is by and between Maria Palacios (herein referred to as the licensed Zumba®️ Instructor) and ‘FULL NAME’ from top section of this form (herein referred to as the participant).

By signing this agreement electronically, you hereby agree to the following:
1. I am participating in a Zumba®️ Class offered by a licensed Zumba®️ Instructor during which I will receive a cardio-dance workout following the Zumba®️ formula. I recognize that Zumba®️ requires physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
2. I understand that it is my responsibility to consult a physician prior to and regarding my participation in this Zumba®️ Class. I represent and warrant that I am physically and mentally fit and I have no medical condition that would prevent my full participation in the Zumba®️ Class. Special circumstances or known illnesses are to be reported to the licensed Zumba®️ Instructor independently before the Zumba®️ Class.
3. In consideration of being permitted to participate in the Zumba®️ Class, I agree to assume full responsibility for any risks, injuries, or damages, known or unknown, which I might incur as a result of participating in the program.
4. In further consideration of being permitted to participate in the Zumba®️ Class, I knowingly, voluntarily, and expressly waive any claim I may have against the licensed Zumba®️ Instructor for damages, and injury, including death, that I may sustain as a result of participating in the Zumba®️ Class.
5. I, my heirs, or legal representative forever release, waive, discharge and covenant not to sue the licensed Zumba®️ Instructor for any injury or death caused by my voluntary participation in the Zumba®️ Class.

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

 

For more information contact:

Maria Palacios, [email protected]