|
RELEASE
FORM
I
_________________________ certify and acknowledge:
1)
That Maria D'Agostino, an independent Personal Trainer, has
advised
me, prior to my commencement of participation in a cardiovascular
and
weight training program, that such participation could result
in
physical injury.
2)
That I _____________________ freely and knowingly
assume the risks in such program and I hereby waive any
right, claim or cause of action against Maria D'Agostino and
release
her from any liability for any injury, cost, damage, expense
or claim,
which I or anyone on my behalf might have as a direct or indirect
result
of my participation in this cardiovascular and weight training
program.
3)
That:I ________________________ have read the foregoing, understand
and agree with each of the foregoing and have received a copy
of this
Release Form on the date described below.
Print
Name _________________________
Date _____________________
Signature __________________________
718 967-6160 | 
Certifications