Waiver & Personal Information 2023
Ritual Studio: Personal Training & Kinesiology Waiver
Sign in to Google to save your progress. Learn more
Full Name *
Phone Number *
Email *
Emergency Contact #1 Name *
Emergency Contact #1 Phone Number *
Emergency Contact #2 Name
Emergency Contact #2 Phone Number
My Doctor/Surgeon has cleared me for exercise:   *
Required
List any restrictions that may affect physical activity (injuries, heart disease, diabetes, asthma, other). If you have none, please type "none". *
I understand that while participating in this activity at or hosted by Ritual Studio, an unfortunate circumstance could lead to injury or damage to myself or my property. I agree that neither I, my heirs and legal representatives will sue or make claims of any kind for any personal injury, property damage/loss, or death, whether caused by negligence or otherwise. *
Required
 I agree that I have chosen to participate in this activity voluntarily and it is at my own will and own risk. I will participate within my own limits, I agree to inform the instructor of any questions or concerns at any time, and I agree to inform the instructor if I sustain an injury due to this activity. I will fully disclose any pre-existing health problems or conditions that may affect my participation in this activity. *
Required
I agree that Ritual Studio and their staff, contractors and volunteers are in no way responsible for my belongings while I attend the studio. *
Required
All information listed above is true and complete. *
Required
Signature (type full name) *
Date *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms