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Liability release

Hanoi Pole Mania Liability Release

My name is:

 

 

  1. I am aware of the physical risks involved with general exercise and with pole dancing and understand that it is my personal responsibility to consult with my physician prior to my participation in any classes or prior to receiving any instruction. I also understand that if at any time during any class or when receiving any instruction from you and/or your associated instructors that I feel discomfort or strain; it is my responsibility to cease the activity and consult with my physician. I agree that I am solely responsible for the decision to practice pole dancing and that I have no known medical condition which would prevent me from taking part in pole dancing classes or receiving pole dancing instruction. I assume responsibility for any risk or injury that I may sustain as a result of my participation. I also agree and understand that pole dancing is not a substitute for medical treatment or attention and that I should consult with my physical prior to beginning any new activity program including pole dancing.
  1. I will not hold Hanoi Pole Mania, its owners, associated instructors, and employees, responsible for any injuries suffered by me caused in whole or in part of my failure to follow the instruction given, or by any physical impairment of mine. I understand that it is my responsibility to advise you, your staff, and your associated instructors of any physical conditions that may limit my participation in pole dancing classes and to work only within my limitations.
  1. I hereby agree to irrevocably release and waive any claims that I have now or hereafter may have against Hanoi Pole Mania, its agents, owners, directors, instructors, sponsors, and other participants as well as any similar claims against the owners, lessor, and lessees of the premises of the studio as a result of my participation in any Hanoi Pole Mania class or event.
  1. I agree that Hanoi Pole Mania is not responsible in the event of loss, damage, unauthorized use, theft, or injury resulting from and to any personal property that I bring onto the premises.
  1. I understand that Hanoi Pole Mania reserves the right to refuse admittance to anyone that Hanoi Pole Mania or the agents thereof think may pose a health risk to themselves or to others.

 

 

Date:

Signature:

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