NIKO'S LAIR A Dance & Aerial Fitness Studio, LLC

WAIVER AND LIABILITY RELEASE FORM

I have entered in a fitness program offered by Niko’s Lair A Dance & Aerial Fitness Studio, LLC. I recognize that the program and or session may involve strenuous physical activity including but not limited to strength, cardiovascular, and endurance training and conditioning. I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition which would prevent or limit my participation in this program and or session. I acknowledge that my subsequent participation is purely voluntary.

In consideration for my participation in this program and or session, I hereby release Niko’s Lair A Dance & Aerial Fitness Studio, LLC from any liability, claims, demands, and causes of action now and in the future as a result of my voluntary participation.

I recognize and acknowledge that there are certain risks of physical injury when participating in pole fitness and I agree to assume the full risk of any injuries, including but not limited to muscle pains, muscle tears, broken bones, death, damages, or loss regardless of severity which I may sustain as a result of participating in any and all activities connected with or in any way associated with pole fitness and dance.

I further agree to hold harmless and defend Niko’s Lair A Dance & Aerial Fitness Studio, LLC from any and all claims resulting from all injuries, damage and losses sustained by me, arising out of, connected with, or in any way associated with my participation in pole fitness.

In the event of an emergency, I authorize medical attention from any licensed hospital, physician, and/or personnel any treatment deemed necessary for my immediate care and agree that I will be responsible for payment of any and all medical services rendered. Furthermore, in the event of an emergency, I release Niko’s Lair A Dance & Aerial Fitness Studio, LLC from any liability, claims, demands, and cause of action now and in the future as a result of my voluntary participation.

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