838 State Farm RD,  Boone, NC  28607 | (828) 386 - 1172  

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Studio Liability Release
AGREEMENT OF RELEASE AND WAIVER OF LIABILITY FORM:  
1. That by participating in a movement class, workshop, or event offered by the Boone Healing Arts Center, I understand that they may require some physical exertion, which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. I fully understand and acknowledge that any cooking class, workshop, or event has inherent risks, dangers, and hazards and that my participation in such classes, workshops or events may result in injury or illness.

2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any movement class, workshop, or event. I represent and warrant that I am physically fit and I have no medical condition that would prevent my full participation in this program.
*Please notify your instructor of any medical condition or health information that the instructor should know about that may affect your participation in this movement class, workshop, or event,

3. In consideration of being permitted to participate in any movement classes, workshops, or events at the Boone Healing Arts Center, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the movement class, workshop, or event.

4. In further consideration of being permitted to participate in any movement classes, workshops, or events, I knowingly, voluntarily and expressly waive any claim I may have against the Boone Healing Arts Center, its owners, and program sponsor, for any injury or damages that I may sustain as a result of participating in the program.

5. I, my heirs or legal representatives, forever release, waive, discharge and covenant negligence or other acts.

I have read the above release and waiver of liability. I voluntarily agree to the terms and conditions stated above.

Participant Signature:___________________________________________Date:________

*If participant is under 18 years of age:

As Legal Guardian of ___________________________, I consent to the above terms and conditions.

Legal Guardian Signature _____________________________ Date:_________