Participant Name (Minor): ____________________________
Date of Birth: ____________________
Parent/Guardian Name: ____________________________
Phone: ____________________ Email: ____________________
NOTICE TO THE MINOR CHILD’S NATURAL GUARDIAN READ THIS FORM COMPLETELY AND CAREFULLY. YOU ARE AGREEING TO LET YOUR MINOR CHILD ENGAGE IN A POTENTIALLY DANGEROUS ACTIVITY…
1. Acknowledgment of Risks
I, the undersigned parent or legal guardian, understand that participation in Pilates group classes involves physical exertion and inherent risks, including but not limited to muscle strain, falls, or other injuries.
2. Voluntary Participation
My child’s participation is voluntary and I acknowledge the risks associated with the activity.
3. Release & Waiver of Liability
I hereby release Fuego Pilates LLC and Fuego Pilates DFM LLC and its agents from any and all liability, except for gross negligence or intentional misconduct.
4. Indemnification
I agree to indemnify and hold harmless Fuego Pilates LLC and Fuego Pilates DFM LLC from any losses arising from my child’s participation.
5. Medical Authorization
In case of emergency, I authorize staff to secure medical care and agree to assume related costs.
6. Compliance with Rules
My child agrees to comply with all studio rules and instructor directions.
7. Governing Law
This agreement shall be governed by the laws of Florida and enforceable in Lee County.
8. Signatures
Parent/Guardian Signature: ______________________ Date: ____________
Print Name: ______________________
Minor Signature: ______________________
Date: ____________
Studio Representatives: Amy Majewski, owner, Fuego Pilates LLC and Jennifer Leach, Owner, Fuego Pilates DFM LLC