On the Mat Pilates Registration

This field is required
This field is required
Please provide the month, day, and year in 2 digits, 2 digits, and 4 digits respectively
This field is required
This field is required
Select your class date. (Select all that apply) Please select at least one option
How did you hear about the program Please select at least one option

BREC WAIVER/RELEASE FORM

By participating in or using any activities, programs, equipment or facilities available through the Recreation and Park Commission for the Parish of East Baton Rouge (BREC), participant/user hereby agrees to the following terms and conditions:
I understand and agree that there is a risk of serious injury to me while utilizing BREC facilities, equipment, and programs and recognize every activity has a certain degree of risk, some more than others. By participating, I knowingly and voluntarily assume any and all risk of injuries, regardless of severity, which from time to time may occur as a result of my participation in recreational and other activities through BREC.
I hereby certify I have adequate health insurance to cover any injury or damages that I may suffer while participating, or alternatively, agree to bear all costs associated with any such injury or damages myself. I further certify that I am in good health and have no mental or physical condition or symptoms that could interfere with my safety or the safety of others while participating in any activity using any equipment or facilities of BREC. To the extent I have any questions or need any information about my physical or mental condition or limitations, I agree to seek professional advice from a qualified physician.
Further, I hereby RELEASE AND HOLD HARMLESS, BREC, and its respective officers, employees, student workers, student interns, volunteers, agents, and representatives, from any and all liability, claims, damages, costs, expenses, personal injuries, illnesses, death or loss of personal property resulting, in whole or in part, from my participation in, or use of, any facility, equipment, and/or programs of BREC.
By entering a BREC facility, I consent to being the subject of any photography, audio, or video recordings, which may take place while I am participating in programming and/or open recreation activities. Such photography and recordings may be utilized by BREC.
The undersigned waive any and all claims, and agree to indemnify and hold harmless BREC and its agents in the event of any injury to the undersigned or minor participant.
I understand that this waiver/release is a contract. I expressly state that I have read, understand and am familiar with all its provisions and that I sign it of my own free will. I also agree to the follow the rules and information provided in a separate document or explained by BREC staff.

Waiver Agreement Please select at least one option