PRAXIS
NORTHEAST PILATES
PJO ON DEMAND
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PRAXIS
NORTHEAST PILATES
PJO ON DEMAND
Email Signup
Northeast Pilates Liability Release
Name
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Street Address
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City / State / Zip
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Cell Phone Number
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Email address
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Emergency Contact Name
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Emergency Contact Phone Number
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Workshop or Course Name
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Workshop Date or Course Start Date
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Workshop or Course Location
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NEP at Praxis, Beverly, MA
Virtual
Benefitness in Rhode Island
Symmetry Pilates in New Hampshire
Impact Pilates in Boston
Canyon Ranch
Other
If "other" location, please specify
Do you hold any of the certifications below?
ACE
CanFit Pro
REP
Do you consent to receiving CEMs (Commercial Electronic Messages) from Merrithew™? If you do not, you will be removed from all communications with Merrithew.
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By typing your name below, you consent to the following Liability Release. I subscribe to and accept the following: Praxis Performance & Wellness, Inc. dba Northeast Pilates Education Centers hereafter known as NEPEC shall not be liable for any damages arising from any personal injuries sustained by a guest, client or a student on or about the premises of NEPEC or Hosting Facility. A guest, client or a student using NEPEC or Hosting Facilities and equipment, does so at his/her own risk. A guest, client or student assumes full responsibility for any injuries or damages which may occur to him/her using said facilities and he/she does hereby fully and forever release and discharge NEPEC or Hosting Facilities, its owners, employees and agents from any and all claims, demands, damages, rights of action or causes of actions, present or future, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of a guest’s, client’s, or student’s use or intended use of NEPEC or Hosting Facilities and equipment. I warrant, represent and agree that I am in good physical condition and have no disability, impairment, ailment, or pregnancy preventing me from engaging in active or passive exercise or that will be detrimental to health, safety, comfort, or physical condition if I do so engage or participate. NEPEC or Hosting Facilities shall not be liable for the loss or theft of, or damage to the personal property of a guest or a member. I agree to keep and obey all the rules and regulations now in force or prescribed by NEPEC and its Hosting Facilities for the use of its facility and equipment.
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