Name
*
First Name
Last Name
Email
*
Cell
*
(###)
###
####
Date Of Birth
Day/Time
*
check all that work for you in general
Mornings Any Day: 8, 8:30, 9a
Evenings: Wednesday 5, 5:30, 6p
Evenings: Thursday 5p
Saturday 9:30a, 11a
Option
Other days/times you want a class:
Locations
*
which areas work for you
Lake Gregory | Crestline
Rim Forest | Twin Peaks
Sky Forest | Lake Arrowhead
Running Springs | Arrowbear
Big Bear
Types of class you want:
*
Check all that apply
Classic Flow
Restorative
Kundalini
Mommy + Me
Pre Natal
Virtual/Online/Zoom
Beginner
Mid Level
Advanced
Health history: injuries, medications, health or medical considerations to share prior to engaging in physical exercise:
*
Experience Level: beginning, regular practice, advanced:
*
Please read and check to agree to the following prior to arrival, thank you.
*
I acknowledge that this Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity.
I hereby assume any and all risks of participation in any and all activities associated with this event, including by way of example and not limitation, any risks that may arise from negligence or unintentional carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.
I certify that I am physically fit, have sufficiently prepared, trained or will be trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity.
In consideration of permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: In consideration of permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, or participating in this activity. (B) THE FOLLOWING ENTITIES OR PERSONS: Tancie Trail, dba PURE, dba estPURE.co, San Bernardino County, and any other participants and volunteers. INDEMNIFY, HOLD HARMLESS, promise not to sue nor pursue other legal action against the entities or persons mentioned in this waiver from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.
I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity.
I certify that I have ready the above items, I understand them fully, i am aware that this is a release of liability and a contract and I sign it of my own free will.