Waiver — Keisa Parrish

First Time Waiver

Please fill out the waiver below. This waiver is good for 1 year. If any of your conditions change please let Keisa know so that she can update your file.

Name

First Name

Last Name

Date

YYYY

Have you practiced Fitness/Yoga/Pilates before?

If yes, what level would you consider yourself?

You’d like to engage in fitness/Yoga/Pilates for which of the following reasons?

Physical Conditions (Please check all that apply)

Release Waiver

Keisa Parrish agrees to provide Yoga instruction to the undersigned in exchange for payment. The student agrees not the hold Keisa Parrish liable for any injury, accidental or otherwise. Be signing this agreement, the student certifies that they are I) not suffering from any physical injuries which have not been disclosed, II) that they have had a physical exam within the last year, III) there is no reason why a medical doctor would recommend that they do not participate in the programs offered by Keisa Parrish. All fees are non-refundable. Please type your name below as your signature. Thank you!

First Time Waiver

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