First Time Student
Waiver

Please be sure to fill out the below waiver prior to your first class at Lemuria.

Lemuria Liability Waiver

First Name

Last Name

Date of Birth

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

Yes

Please specify any injury or anything else we should know about

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 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, including pregnancy, which may affect my ability to participate in this program.

I recognize that all class fees are non refundable. Classes are reserved online only. Please note our cancellation policy is $10 cancellation fee without a three hour notification. Please cancel your reservation online three hours prior to class to avoid the fee.

Thanks for submitting!

First Time Student Waiver

Lemuria Liability Waiver

First Time Student
Waiver