Accuracy of Information:
I certify that the above personal and medical information is correct to my knowledge on behalf of myself or acting as a parent/guardian for the registrant. I certify that a parent/guardian has read, agreed to and signed this waiver, if participant is under the age of 18 years.  

Privacy of Personal Information:
I authorize Empower Physiotherapy to collect my personal and medical information as documented above. I understand my personal information will be stored securely.

General Waiver and Policies
1) Permission is received for the registrant to attend the registered Empower Physiotherapy’s Summer Strength & Stretch Hybrid (online and in person) Classes with Sara Lawson and/or Xiamara Foster on Wednesday evenings July 8-29 2020, if under age 18 years.  

2) Authorization is received for all employees, independent contractors, or volunteers associated with Empower Physiotherapy's Summer Strength & Stretch, to use without any compensation whatsoever the registrant’s images or photography or videography for conducting the Zoom Videoconferencing option of the class; and advertising, promotional purposes and publicity purposes including but not limited to printed and web-based material.

3) The Registrant for the Summer Strength & Stretch hereby releases, discharges, and acquits Empower Physiotherapy, Empower Dance & Wellness and its employees, volunteers, independent contractors, and associates from any and all claims for losses, damages, or injuries/illnesses of any kind, nature, or description resulting from or related in any way to the participation in the event.  I understand and accept and release Empower Physiotherapy/Empower Dance & Wellness from any and all risks associated with accessing Zoom.us videoconferencing.  

4) Empower Physiotherapy, Empower Dance & Wellness and all employees, volunteers and independent contractors assume all participants are in good health and fit to attend the Summer Strength & Stretch classes.  It is acknowledged and accepted that if a participant has: travelled outside of Canada in the past 14 days, has had contact with a person who has had or suspected of COVID-19, and/or has the new onset of a cough, sore throat or fever; they will not be allowed to participate in the In person class and can be transferred to the online Zoom link to participate.  There will be mandatory hand washing and optional use of masks in the public areas of Evolution Fitness East along with a checklist for COVID-19 at each in person session. It is acknowledged and agreed upon that all participants attending the Summer Strength & Stretch classes take certain and inherent risks of physical injury or illness of various extent. These risks include but are not limited to exposure to viruses, sprain, strains, bruises, and broken bones. Participation in the Summer Strength & Stretch indicates the acceptances of such risks and release of liability of Empower Physiotherapy for such risks, by the registrant or acting parent/guardian. In the event of physical injury and/or illness, it is authorized for the instructor of the Summer Strength & Stretch classes, to use reasonable discretion, on behalf of the registrant participating in the classes, in contacting the emergency contact listed if arranging for emergency medical care is required (including any required hospitalization), at the expense of the registrant or legal guardian/parent of the registrant.

5) Empower Physiotherapy/Empower Dance & Wellness reserves the right to refuse admittance to the Summer Strength & Stretch Class or to eject anyone who is disruptive, unruly, or displaying rude, unacceptable behaviour which will be determined at the Instructor's sole discretion.

6) The performance of this agreement by either party is subject to acts of God, government authority, disaster, civil disorders, strikes, or other local and national emergencies, any of which make it illegal or impossible to provide the facilities and/or services for the Summer Strength & Stretch Class. It is provided that this agreement may be terminated for any one or more such reasons by written notice without liability.

7) The registrant or acting legal parent/guardian of the registrant, understands that if sufficient enrolment is not obtained, Empower Physiotherapy/Empower Dance & Wellness reserves the right to cancel the Summer Strength  with written notice from one party to the other and all monetary payments will be returned to the undersigned. It is understood that in person location, faculty and scheduling are subject to change and notice will be provided to the registrant.

8) The registrant understands this is a class conducted for the purposes of education and physical training.The registrant understands the class payment is due at the time of registration via e-transfer directly to empowerphysioyqr@gmail.com.  Receipt of payment and signing liability forms are required for Zoom Link and Password to be released to the participant prior to the Online Class or for admittance to the In-person class.  

I acknowledge I have read and understood the Waiver and I am electronically agreeing, accepting, and signing the waiver on behalf of myself or as an acting parent/guardian for the registrant.  It is understood that the waiver has been completed by the acting parent/guardian for underage participants (less than 18 years of age at time of the event).  Electronic signature is indicated through the checkbox below.