2nd Street Studio
644 North 2nd Street
Breese, IL 62230
618-526-0777

ACKNOWLEDGMENT AND RELEASE OF LIABILITY

By executing this document, I acknowledge that Donna Rolfingsmeyer and her employees, d/b/a 2nd Street Studio, have advised me of the physical challenges of the various programs they offer. They have advised me that I should consult my physician before beginning any exercise regimen. It is my decision whether I choose to do so.


On behalf of myself, my heirs, personal representative and assigns, I hereby release and forever discharge Donna Rolfingsmeyer and her employees, d/b/a 2nd Street Studio, from all claims, damages and liability incurred by reason of my participation in the programs at 2nd Street Studio. This includes, but is not limited to, personal injury, medical expenses, lost income and charges and expenses arising from those losses.



I am aware of the following: Money will not be refunded for any reason.* Payment is due before the first class begins. We accept a personal check or cash. There is a $15.00 charge for all returned checks. Children are not allowed in or around the studio during workout sessions, unless the child is a client. I am to bring my workout shoes as no street shoes are permitted on workout floor.


Dated: ________________________



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Participant

*Maximum class size is 25 participants. Minimum class size is 10 participants If class is filled or cancelled you will have the opportunity to receive a refund.