Selformer Minor Participation Waiver and Release

Minor's Full Name

Minor's Date of Birth

Month

Day

Year

Name of Class/Sevice

Date and time of class

Month

Day

Year

Time

Location

Allergies, Medications, or Medical Conditions We Should Know About (if any)

Parent/Legal Guardian Full Name

Relationship to Minor

Phone

Parent/Legal Guardian Consent : I am the parent or legal guardian of the minor named above and give my permission for them to participate in activities at Selformer, including Reformer Pilates group classes and, where applicable, Selformer's self-led Video Room services.

I understand that Pilates and fitness activities involve inherent risks, including but not limited to muscle soreness, strains, sprains, falls, equipment-related injuries, and other unforeseen injuries. I voluntarily assume these risks on behalf of the minor.

I confirm that the minor is physically able to participate and does not have any medical condition that would make participation unsafe without prior medical approval.

I, the parent/legal guardian, and the participant have read and understood all of Selformer's studio policies.

Self-Led Video Room Services I understand that Selformer's Video Rooms are self-guided workout spaces and are not supervised by an instructor. Participants follow pre-recorded workouts independently and are responsible for exercising within their own abilities.

I acknowledge that it is the responsibility of the participant and parent/legal guardian to use the equipment safely, follow all posted instructions and studio policies, stop exercising immediately if discomfort or injury occurs, and seek assistance from studio staff if needed.

I understand that Selformer staff do not provide instruction or supervision during Video Room sessions, and participation is entirely voluntary and at the participant's own risk.

Release of Liability To the fullest extent permitted by law, I release and hold harmless Selformer, its owners, employees, instructors, contractors, and representatives from any claims, demands, liabilities, damages, costs, or expenses arising from or related to the minor's participation in any Selformer class, service, or activity, including the use of the self-led Video Rooms, except where caused by gross negligence or willful misconduct.

Studio Policies I understand and agree that the minor will follow all studio rules, safety instructions, and staff directions, including the proper use of equipment and required studio policies.

I understand that failure to follow studio policies may result in the participant being asked to discontinue the session without a refund.

Emergency Medical Care In the event of an emergency, I authorize Selformer to seek emergency medical treatment for the minor if I cannot be reached immediately. I understand that all medical expenses are my responsibility.

I authorize Selformer to seek emergency medical treatment for the minor as described above, and understand that all resulting medical expenses are my responsibility.

I certify that I am the parent or legal guardian of the minor listed above, have the legal authority to sign this waiver, have read and understood its contents in full — including the assumption of risk, self-led Video Room terms, release of liability, and studio policies — and voluntarily agree to its terms. I further certify that, to the best of my knowledge, the minor is in good health and in the physical condition necessary to safely participate in this class.

I give Selformer permission to use photos or videos of the minor taken during class for studio marketing and social media purposes, if the minor is enrolled in a film-friendly class."

Printed Name (Parent/Legal Guardian)

Signature

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Selformer Minor Participation Waiver and Release

Minor's Full Name

Minor's Date of Birth

Month

Day

Year

Name of Class/Sevice

Date and time of class

Month

Day

Year

Time

Location

Allergies, Medications, or Medical Conditions We Should Know About (if any)

Parent/Legal Guardian Full Name

Relationship to Minor

Phone

I confirm that the minor is physically able to participate and does not have any medical condition that would make participation unsafe without prior medical approval.

I, the parent/legal guardian, and the participant have read and understood all of Selformer's studio policies.

I understand that Selformer staff do not provide instruction or supervision during Video Room sessions, and participation is entirely voluntary and at the participant's own risk.

Studio Policies I understand and agree that the minor will follow all studio rules, safety instructions, and staff directions, including the proper use of equipment and required studio policies.

I understand that failure to follow studio policies may result in the participant being asked to discontinue the session without a refund.

I authorize Selformer to seek emergency medical treatment for the minor as described above, and understand that all resulting medical expenses are my responsibility.

I give Selformer permission to use photos or videos of the minor taken during class for studio marketing and social media purposes, if the minor is enrolled in a film-friendly class."

Printed Name (Parent/Legal Guardian)

Signature

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