Group Classes Waiver Form

Rebellious Client Intake and Waiver Form

Before we get started working together, I have some questions for you to help me determine the program that will best fit your current needs.

Group Movement Classes

Mondays at 9am EST

Wednesdays at 7:15pm EST

Group Mindset Classes

Mondays at 5pm EST

Waiver & Acceptance of Terms

Please fill out the form below.

I agree that all use of Rebellious Int’l, LLC facilities and services shall be undertaken at my own risk, and that I am physically, mentally, and emotionally able to undertake any and all physical, mental and emotional exercises or have consulted a physician before participating. I also agree that Rebellious Int’l, LLC shall not be liable for any claims, injuries, or damages to me connected with the use of the services and/ or facilities, and I do hereby expressly release and discharge Rebellious Int’l, LLC from all such claims.

I hereby grant permission to Rebellious Intl LLC to use photographs and/or video taken of me in publications, news releases, online, newsletters and in other communications related to the company.

Yes

Your acceptance of the Services provided by Rebellious is subject to the Terms of Service (“Terms”) posted on our website. By signing below, you agree to these Terms, acknowledge that the Terms apply to your participation in the Services, and consent to participate in the Services.

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Rebellious Client Intake and Waiver Form

Waiver & Acceptance of Terms

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