top of page

Home
Events
- Waiver
About
Shop
Testimonials
Blog
Contact
More

Use tab to navigate through the menu items.

S H E R I E S L O A N E

Release & Liability Waiver

Please fill out with your information or your child's information if attending a Kids Class or Event.

First name

Last name

Email

Date of Birth

Do you have a doctor’s permit to participate in sports/ physical activities

No

Yes

Please specify anything we should know about or any physical limittions that could be aggravated by exercise.

Initials

I declare that the info I’ve provided is accurate & complete

I hereby acknowledge this release from liability for accidental injury or illness which I/ my child may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.

Address

Emergency Contact Number

Emergency Contact Person

Thanks for submitting!

©2022 SHERIE SLOANE

bottom of page