I currently host ONE free Live class monthly in all different locations! If you'd like to have this free class at your gym, studio, or for a club, youth group, or any other setting, please fill out the form below!
if you'd like to register for a class, please fill out the form below!
PiYo Live Waiver & Release Form
*** PLEASE READ CAREFULLY! *** THIS IS A RELEASE OF WAIVER OF CERTAIN LEGAL RIGHTS Agreement of Release & Waiver of Liability I hereby agree to the following: Enter full name above 1. That I am voluntarily participating in classes or programs offered by Harmony Patton also known as The Paleo Ballerina during which I will receive information and instruction about fitness. I understand that there are inherent risks associated with PiYo training, strength training and other forms of vigorous physical activity. I recognize that this fitness program requires physical exertion that may be strenuous and may cause physical injury. Participation in this PiYo fitness program may result in acute muscle and/or joint pain, pulled muscles, brief changes in blood pressure, light headedness, dizziness, delayed onset muscle soreness, more chronic conditions such as tendinitis, and other discomforts. I am fully aware of the risks and hazards involved. 2. I understand that physical contact is an integral part of this exercise program and is done in a therapeutic manner. 3. I realize that there are many other risks of injury, including serious disabling injuries, heart attack, paralysis, stroke and even risk of death, and that it is not possible to specifically list each and every injury which may arise. These risks and dangers may be caused by the negligence of Harmony Patton, the negligence of participants, the negligence of others, accidents, or other causes. I hereby freely and expressly agree to assume full responsibility for any risks, injuries or damages, known or unknown, and death that I might incur as a result of my participation in this class or program. 4. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the classes that I am taking with the Harmony Patton. If I have chosen not to obtain a physician’s permission prior to beginning this exercise program with Harmony Patton, I hereby agree that I am doing so at my own risk. I represent and warrant that I am both physically and mentally fit to fully participate in these classes and programs offered by Harmony Patton. 5. I further confirm that I have fully disclosed to Harmony Patton all my injuries and illnesses past and present. In addition, I agree to report any changes in my physical and mental condition to Harmony Patton immediately. And, if I feel any discomfort in performing a given exercise, I understand that it is my responsibility to stop and inform Harmony Patton immediately. 6. In further consideration of being permitted to participate in classes and programs with Harmony Patton, I knowingly, voluntarily and expressly waive any claim I may have against Harmony Patton for injury or damages, including but not limited to, heart attacks, muscle strains, pulls or tears, broken bones, shin splints, heat prostration, knee/lower back/neck/foot injuries an any other illness, soreness or injury, however caused, that I may sustain, now or in the future, as a result of participating in the class and program. 7. On behalf of myself and my heirs, personal and legal representatives and assigns, I hereby forever release, waive, covenant not to sue, and discharge Harmony Patton and her heirs from any and all claims, demands, rights, causes of action, judgments, costs and expenses (including reasonable attorneys’ fees) or other liability of whatsoever kind or nature resulting from my participation in or in any way connected with the class or program offered by Harmony Patton, including but not limited to, any and all bodily and personal injuries (including death) or damage to property, caused by her negligence or other acts. 8. I understand that Harmony Patton has the right to refuse service to anyone she feels is inebriated or drugged or whom she feels may be in a comprised state rendering the participant unfit for exercise. By entering my name on this digital form I hereby affirm that I have read the above release and waiver of liability and fully understand its contents. By checking the box and entering my information below I agree to participate in this PiYo class and program AT MY OWN RISK. I voluntarily agree to the terms and conditions stated above.
These free PiYo Live Classes are hosted monthly! If you would like to request the next months location then please send an email to firstname.lastname@example.org
All future events will be listed soon!
If you would like more information on purchasing the full at home PiYo program and having The Paleo Ballerina as your coach, then please click HERE!