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Iyengar Class

liability waiver

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         I certify and acknowledge that I hereby knowingly and voluntarily execute this Waiver with Challenge to Change, which will be providing services at a fitness center, client’s home, Challenge to Change office, or other location as deemed appropriate by Challenge to Change (hereinafter, “Location”), with said training services to be provided pursuant to a specified schedule with. Further, I acknowledge and am hereby advised that participation in cardiovascular, aerobic exercise, stretching exercise, running and weight lifting, as well as additional strenuous exercise and/or exertion of strength, and other sustained physical activities, which place stress upon the cardiorespiratory and muscular systems (collectively referred to as “Training”) are and can be hazardous activities that include certain risks and dangers, including but not limited to injury, paralysis, or other serious injury and possibly death.


      By signing this Waiver I freely and knowingly assume the risk in such Training, and I hereby waive any right, claim or cause of action against Challenge to Change, and further release it from any liability for any injury, cost, damage, expense or claim, which I or anyone on my behalf may incur as a direct or indirect result of my participation in a Challenge to Change training program.  I acknowledge that at times certain equipment may be used in the course of training, and I further acknowledge and am hereby advised that Challenge to Change has not inspected the equipment at the Location for the suitability for training[1] [2] . I expressly release, hold harmless, and discharge Challenge to Change for any liability associated therewith, and release Challenge to Change for any loss, injury or damage from any cause, including negligence arising out of any Location, and/or arising out of the use of any equipment utilized during training. I understand that Challenge to Change will not in any event provide medical and/or hospitalization insurance for my benefit, and that in the event of any injury to my person occurring either as a result of my participation in any training provided by Challenge to Change, wherever said training is provided, I will hold harmless and indemnify Challenge to Change and their respective trustees, beneficiaries, staff and officers from and against any and all actions, claims, costs, expenses, or demands with respect to any said injuries, including death, howsoever caused, arising out or in connection with my training through Challenge to Change at whatever location said injury may occur.


      I represent to Challenge to Change that I have either been given a physician’s permission to participate in said training or voluntarily participate in said training and accept all risks relating to said training, without the approval of my physician. I further represent that I am not aware of any medical or physical condition which would prevent me from participating in the training, or from using any equipment or facilities associated therewith. I further acknowledge and agree that I am not obligated to participate in any Training that I do not wish to participate in. I agree to inform Challenge to Change immediately if I do not wish to participate in any specific Training. I am voluntarily participating in any Training based upon the information that has been provided to me.


   I further state that I have read this Liability Waiver Form and understand and agree with each of the foregoing points.

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