Yoga, Pilates & Movement
 
Name:                                                                                                Date:
Email:                                                                                                Phone:
 
Addendum: CORONAVIRUS/COVID-19
 
COVID-19 has been declared a worldwide pandemic by the World Health Organization. COVID-19 is an extremely contagious and is believed to spread mainly from person-to-person contact. SPIRIT MOVES has put in place preventative measures to reduce the spread of COVID-19. However, SPIRIT MOVES cannot guarantee that you will not become infected with COVID-19.
 
Assumption of Risk: By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19, and that such exposure or infection may result in personal injury, illness, permanent disability or death. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury, illness, damage, loss, claim, liability, ore expense, of any kind, that I may incur.
 
WAVIER OF LIABILITY: I hereby release, covenant not to sue, discharge and hold harmless SPIRIT MOVES, Yoga, Pilates and Movement, its employees, agents, representatives, from all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating to COVID-19.
 
I attest that:
* I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
* I have not traveled internationally within the last 14 days.
* I have not traveled to a highly impacted area within the United States of America in the last 14 days.
* I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
* I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non- contagious by state or local public health authorities.

* I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.
 
Please read carefully; I hereby agree to the following:
I agree and acknowledge that I am fully aware that participation in this activity may involve risks and I accept all the risks of participating. I will progress at my own pace and I understand my physical limitations so I am sufficiently self-aware to stop physical activity before I become ill or injured I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the Yoga, Pilates & movement classes. In consideration of being permitted to participate in classes, I knowingly, voluntarily, and expressly waive any claim I may have against Spirt Moves for injuries or damages that I may sustain as a result of participation in classes. My signature acknowledges that I shall not now, or at any time in the future, bring any legal action against Spirit Moves, Anne Nelson or any other person who may teach at Spirit Moves; and that waiver is binding on me, my heirs, my children, my legal representative, my successors and my assigns. If I am pregnant, or become pregnant or am postnatal, my signature verifies that I am participating in Yoga, Pilates and movement with my full doctor’s approval. Any other medical conditions that need a physician’s approval shall be included such as medical, surgical, disabilities or chronic condition or disease. If you are under 18, you must have parent’s signature. My signature is binding to this liability from this day forth.
 
 
Signature:                                                                                                        Date:
 
Spirit Moves, Yoga, Pilates & Movement. 8 Mill Village Pentway, North Stonington, CT 06359
www.spirit7moves.com, spirit7moves@gmail.com, 860-535-0565 (home) 860-460-5498 (cell)