I hereby agree that by signing this document, I consent to waive certain legal rights, including the right to sue the following party, and, if applicable, its managers, members, agents, employees, owners, trainers, representatives, and facilities from any physical, material, tangible or intangible, loss or damages that may happen to me during my participation in any of aspect of the Pole + Pregnancy OR Pole + Postpartum courses (hereinafter, “Course) undertaken while under their instruction or thereafter: Dr. Emily Rausch, PLLC (the "Provider").

I acknowledge that physical exercise and training can be strenuous and subject to the risk of serious injury. I agree to hold the Provider, harmless from any damage, whether tangible or intangible, that may happen to me while participating in the course. Such injuries may include, but are not limited to, pregnancy or postpartum concerns/complications, muscle strains, muscle sprains, muscle spasms, heart attacks, raised blood pressure and broken, fractured, or dislocated bones.

It is my responsibility to consult a physician before participating in this or any fitness program and I affirm that I have no medical conditions that would restrict me from participating in any portion of the course. I acknowledge that Dr. Emily Rausch has not performed such an examination and does not certify my physical readiness.

I agree that the Provider offers the course with no guarantee of results. I agree that I am solely responsible to maintain the fitness regime appropriate for my level of health and stamina, and I agree that any results that occur, whether positive or negative, are the effects of my own personal choices or by conditions outside of the control of the Provider.

I acknowledge that this course and the exercises recommended by Dr. Rausch do not constitute chiropractic treatment/therapy and she is not acting or treating in the capacity of a chiropractic physician throughout the duration of this program. If I desire chiropractic treatment, I acknowledge that there is a separate and independent process for initiating and obtaining these services.

I agree that participation in the course is not a replacement for actual medical care and that if I do experience medical issues, I will contact my doctor immediately.

If I do require medical treatment or attention while or after participating in the course, I agree that the medical costs are mine and mine alone and hold the Provider blameless from any charges, fees, or costs that my conditions may incur.

I understand and am aware that my participation in the course involves risks. These risks may lead to tangible or intangible harm, and I agree that they may result not only from my own actions but also from the actions of others. With the knowledge and understanding of these risks, I choose, of my own will and volition, to continue participating in the course. I am also aware that there are risks that I may not have considered, yet I waive my right to any claims that may occur from these unconsidered risks and I choose, of my own will and volition, to participate in the course.

I agree to defend and indemnify the Provider and any of its affiliates (if applicable) and hold them harmless against any and all legal claims and demands, including reasonable attorney's fees, which may arise from or relate to my use or misuse of the course or my conduct or actions. I agree that the Provider shall be able to select its own legal counsel and may participate in its own defense if desired.

I am over 18 (eighteen) years of age and am medically and physically able to participate in the course.

This Acknowledgement of Risk, Waiver of Liability and Release shall be governed by and construed in accordance with the internal laws of California without giving effect to any choice or conflict of law provision or rule. Each party irrevocably submits to the exclusive jurisdiction and venue of the federal and state courts located in the following county in any legal suit, action, or proceeding arising out of or based upon this Program Waiver: San Diego.

I have read the above Acknowledgement of Risk, Waiver of Liability and Release fully. I understand and agree to its contents. I understand and agree that by signing this Acknowledgement of Risk, Waiver of Liability and Release I forfeit any right, claim, or ability to hold the Provider responsible for any tangible or intangible damages, loss of property, or loss of life that may occur during or after my participation in the course.

This Acknowledgement of Risk, Waiver of Liability and Release will bind and be enforceable against me and all of my personal representatives, heirs, estate, executor, administrator, assigns and all members of my family. I agree it

should be enforceable to the fullest extent of the law, and if any portion is held invalid, the remainder should continue in full legal force and effect. I agree it shall be construed and interpreted as broadly as possible in the applicable jurisdiction. I intend that this Waiver be as broad and inclusive as permitted by law and that this Waiver will remain in full legal force and effect forever, regardless of whether or not I remain a participant in this Course.

No refunds will be provided.  You are agreeing to pay in full based on your payment plan chosen.   

I further agree that no oral representations, statements, or inducements apart from the foregoing Waiver have been made. By electronically signing/signing this Waiver, I have agreed to all of the terms contained above.