Fields marked with and * are required Waiver & Release Form

While training at Lashay Pole Fitness LLC with any of our Independent Contractors teaching classes at Lashay Pole Fitness LLC:

I understand that physical exercise can be strenuous and subject to risk of serious injury. You are urged to obtain a physical examination from a doctor before participating in any exercise activity.

I recognize that such physical activity and exertion may be difficult and strenuous and may cause or aggravate a

physical injury or medical condition.

I agree that I engage in any physical exercise of activity, I do so entirely at my own risks.

This waiver and release of liability includes, without limitation, all injuries which may occur as a result of:

(a) Your participation in any activity or training session and

(b) Instruction, training, supervision by your instructor while at Lashay Pole Fitness LLC

You acknowledge that you have carefully read this "waiver and release" and fully understand that it is a release of

liability. You expressly agree to release and discharge the instructor at Lashay Pole fitness LLC from any and all claims or causes of action and you agree to voluntarily give up or waive your Dance/Pole Instructor for personal injury or property damage.

To the extent that statute or case law does not prohibit release for negligence, this release is also for negligence on the part of the Dance/Pole Instructor. If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to the invalid, then the remained of this release from liability shall remain in full force and effect and the offending provisions severed herefrom.

By signing this release, I acknowledge that I understand its content and that this release cannot be modified orally.