top of page
Log In
Home
Somatic Exercise
Who is this for?
About Me
FAQs
Book Online
Contact Me
Contact Me
Use tab to navigate through the menu items.
Liability Waiver
First name
Last name
Email
Touch consent (Sorry but this field is required even if you are attending virtually. It's hard to have a perfect website): As with any fitness training program, learning proper execution can be aided by appropriate/professional physical contact/cueing. Check the box to indicate your consent to appropriate physical touch cueing.
*
No
Yes
Because physical exercise can be strenuous and subject to risk of serious injury, we urge you to obtain a physical examination from a doctor before using any exercise equipment or participating in any exercise activity. You agree that by participating in physical exercise or training activities, that you are not under medical restriction orders by a medical provider and you have not concealed any serious medical condition on your intake paperwork. You agree to participate entirely at your own risk. You agree that you are voluntarily participating in these activities with The Somatic Salvage Yard’s owner/operator at any site/facility (public, private, or government property) and you assume all inherent risks of discomfort, injury, illness, or death. The Somatic Salvage Yard and it’s owner/operator are also not responsible for any damage/loss of your personal property. You acknowledge that you have carefully read this “waiver and release” and fully understand that it is a release of liability. You expressly agree to release and discharge The Somatic Salvage Yard and it’s owner/operator from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against The Somatic Salvage Yard and it’s owner/operator for personal injury or property loss/damage. To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence. If any portion of this release from liability shall be deemed by a court of competent jurisdiction to be invalid, then the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions severed here from. Please be aware that The Somatic Salvage Yard and it’s owner/operator offers exercise/fitness services and does not offer medical services. A medical diagnosis will not be made, medical treatment will not be provided (beyond first aid/basic life support) and medical insurance cannot be accepted or billed by The Somatic Salvage Yard or it’s owner/operator on your behalf. Upon request, we will provide you with a printed receipt and a synopsis of the exercise methods, which you may choose to submit directly to your insurance. By signing this release, I acknowledge that I understand its content and that this release cannot be modified orally.
I declare that I have read and understand the above liability waiver; that I have no known reason that I should not participte in physical activity; and that I maintain responsbility and personal liability for any outcome from participating.
Your Signature
Clear
SUBMIT THIS FORM
Thanks for submitting!
bottom of page