In order to take part in Move, Dance, Stretch and Barre Fit sessions at Letheringham Lodge, please read and sign the following participation Waiver and Release of Liability:

I, the undersigned, acknowledge that participation in dance and movement classes involves physical activity, which carries a risk of injury. I am aware that falls, collisions, strains, sprains, or other accidents can occur during class, and I accept these risks.

I certify that I am physically capable of participating in the dance class. I have disclosed any pre-existing medical conditions or injuries that may affect my participation (or my child’s participation) in the class. I agree to notify the instructor of any changes to my medical condition prior to attending class.

In consideration of being allowed to participate in the dance class, I hereby release, waive, and discharge Letheringham Lodge, its instructors, employees, agents, and any other associated personnel from any and all liability for injuries, losses, or damages sustained by myself (or my child) as a result of participation in the class, whether caused by negligence or otherwise.

I understand that I am responsible for my own health insurance and medical expenses in the event of an injury or medical emergency during the class.

I agree to follow all instructions given by the instructor and to follow the policies and procedures of Letheringham Lodge. I understand that failure to do so may result in my dismissal from the class without refund.

I agree to indemnify and hold harmless Letheringham Lodge, its instructors, employees, agents, and any other personnel from any claims, actions, or demands arising out of or related to my (or my child’s) participation in the class.

Signature of Participant/s: __________________

Date: __________________

Signature of Parent/Guardian (if under 18): __________________

Date: ______________________