Alyssa Cullen Fit & Well — Waiver & Questionnaire

Contact

Full Name *

Email *

Phone *

Date of Birth

Message

Assumption of Risk, Waiver of Liability, and Indemnification Agreement

I, the undersigned, am either the Client named above or the parent and/or legal guardian of the minor Client named below (if applicable). By signing this form, I acknowledge that:

Any program of physical activity and/or fitness exercise involves a risk of injury.
I (or the under‑18 Client) have recently been examined by a medical doctor and have been cleared to undertake a program of exercise.
In consideration of an exercise program designed by Alyssa Cullen:
- Any exercise program (In‑Person and Online Training) shall be undertaken by the Client at his or her sole risk.
- Alyssa Cullen shall not be liable to Client, nor any other person, for any claims or causes of action arising out of or connected with these services.
- The Client hereby releases and discharges Alyssa Cullen Fit & Well from any such claims or actions.

BY SIGNING BELOW, I confirm I have carefully read these terms, fully understand their content, and I am aware this is a release of liability.

I am signing on behalf of a minor participant (under 18). I am their parent/guardian.

Signature

Client (print full name) *

Date *

Typing your full legal name constitutes your electronic signature.

Keep a copy of this form for your records.