COEUR PILATES 

Informed Liability Waiver and Agreement

The statement below is a required agreement. Be sure to read it.

In order to take part in a postural assessment, private, or duet sessions, and/or group classes, you’ll need to sign this waiver. I cannot issue a full refund.

"I hereby consent to voluntarily engage in movement classes and/or sessions- either in person, or in a virtual/remote session with Erin Wilson of Coeur Pilates (Erin).

I understand that despite Erin's due diligence, she cannot guarantee my safety. I will stop the practice immediately and let Erin know if pain comes along with a movement. I understand that Erin is not a medical professional, and her directions for engagement, movement and homework are optional. Erin may refer me to a doctor and I understand that her doing so is staying within the scope of her practice as a Pilates teacher certified through Pilates Sports Center.

I have been informed that during my participation in the class or training, I will engage in the physical activities arranged by the instructor unless symptoms such as fatigue, shortness of breath, chest discomfort or sharp/unusual pain occur. At that point it is my responsibility to inform Erin of my symptoms and it is my right to take a break, decrease participation or stop exercising.

If I am referred by Erin to a professional, she will opt to suspend any remaining credits for 3 months (90 days), or longer, as needed with written notice. Only partial refunds will be given. In rare circumstances a transfer of classes/sessions will be honored only to someone who has signed and returned this waiver.

I will inform Erin of my need to cancel a class/session in a timely manner by giving her as much notice as possible. Cancellations within 4 hours time may result in a loss of that class/session credit, and will be enforced strictly if it becomes a pattern.

It is my responsibility to inform Erin of any health issues that may affect my practice with her, and I understand that the information collected in the Wellness Questionnaire or during a verbal consultation will be used exclusively for my benefit. If anything changes with my health, medications, and/or circumstances that may affect our practice, I will let Erin know by email, text, phone call, or verbally at the start of our session together.

If Erin consults with any other health/fitness professionals, my identity will remain confidential.

I will be notified as changes are made to cancellation or purchase policy as operations change in light of the Covid-19 pandemic.

I have added the email address "coeurpilatesspace@gmail.com" as one of my contacts, so that I will see email updates from her concerning such changes and updates. I understand that if I choose to unsubscribe, I may miss out on any policy changes or updates. Erin will not re-subscribe me, unless I expressly ask her to do so. I can also subscribe again on my own.

I understand that Erin may provide and/or suggest equipment to use in our sessions together. I take full responsibility for any damage to my person or any others around me as a result of the use of such equipment.

I will make sure I am in a safe place for full body movements and will not take risks that may cause damage.

I hereby waive Erin Wilson, Coeur Pilates, and Rebelle Movement of any and all liability. I have read this text. I agree to adhere to the policies stated here."

PRINTED NAME ____________________________________________

SIGNATURE ________________________________________________ TODAY’S DATE _____________