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Liability Waiver

Please read and complete this intake waiver carefully before participating in any studio activities.

Date of birth
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Required for emergency contact purposes and age verification.

Media & Marketing Consent

Occasionally we may ask to capture photos or short videos of clients in session for education and promotional purposes.
I grant permission for use of my images/videos of me on social media and marketing materials - Yay!
I do NOT grant permission for images/video of me to be used.

Release of Liability

ASSUMPTION OF RISK: Pilates and fitness training involves inherent risks, including but not limited to muscle strain, joint injury, falls or other physical injury. I voluntarily assume full responsibility of risks associated with my participation.


RELEASE OF LIABILITY: I hereby release and discharge Centered Motion Holistic Healing Fitness Studio, its owners, employees and instructors, and affiliates from any and all liability, claims, demands, arising from my participation in studio activites.


MEDICAL CONDITION: I am physically fit and have no medical conditions that would prevent my safe participation in fitness activities. If any known medical conditions exist I agree to consult with a physician to be cleared before beginning any exercise program.


EMERGENCY MEDICAL TREATMENT: I authorize Centered Motion staff to seek emergency medical treatment on my behalf if necessary. Centered Motion reserves the right to postpone or modify sessions until appropriate medical clearance is obtained.

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Pleae sign below to acknowledge your agreement to this waiver.

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