I. RELEASE AND WAIVER
This Release, Waiver of Liability and Covenant Not to Sue/Indemnity (the “Release”) is executed on
this day by the student attending the class (hereinafter, “Student”) in favor jointly and severally of
Pilates by Chelsea and Chelsea Rossi (hereinafter “Owner”) and the premises located at 75 Sand
Creek Road, Town of Colonie, Albany County, State of New York (hereinafter “the Premises”).
Student (on behalf of itself and its agents, heirs and assignee’s), hereby and forever releases, discharges
and holds harmless Owner and Owner’s respective agents, heirs, assigns, contractors, guest instructors,
visiting instructors, employees, volunteers, interns, apprentices, student-instructors—whether paid or
unpaid—landlords, real properties, businesses and the Premises from any and all claims, demands,
damages, rights of action or causes of action, present or future, arising out of or connected with my
presence on the premises, my entry and exit from the premises (including my use of common stairwells,
stairs and hallways), my participation in Pilates classes and/or instruction of any nature (i.e. including but
not limited to so called “self-practice” and/or “private” instruction/lessons), or any activities on the
premises or related to Owner’s negligence and my use of the facilities, equipment, appliances and
premises.
Student hereby and forever releases, discharges and holds harmless Owner and Owner’s respective
agents, heirs, assigns, contractors, employees, real properties, businesses and the Premises from any and
all claims, demands, damages, rights of action or causes of action, present or future, arising out of or
connected with the provision of services by independent 3rd-party service providers who may be sub-
tenants of Pilates by Chelsea or Chelsea Rossi).
Student hereby and forever releases, discharges and holds harmless Owner and Owner’s respective
agents, heirs, assigns, contractors, employees, real properties, businesses and the Premises from any and
all claims, demands, damages, rights of action or causes of action, present or future, arising out of or
connected with any criminal or “intentional” acts of third parties perpetrated while I am present on the
premises or for Owner’s negligence. Student hereby acknowledges and agrees that Owner is not liable for
loss, damage or theft of any personal items/personal property brought onto the Premises whatsoever and
by whomever for whatever purpose.
Student specifically waives any claim that I might have against Owner and Owner’s respective agents,
heirs, assigns, contractors, employees, real properties, businesses and the Premises for Owner’s
negligence under the “social host” laws of the State of New York.
Student hereby, agrees to at all times exercise a high degree of supervision and care over any minor child
that Student shall bring onto the Premises. Owner does not offer any supervision or day care services of
children on the Premises. All minor children entering the Premises must at all times be accompanied by
and closely supervised by an adult.
Photographic and media release: Unless expressly reserved, Student, agents, heirs, licensees and
assignees, hereby grants, worldwide rights and permission to Owner agents, heirs, assigns, contractors,
employees, real properties, businesses and any transferee or licensee to photograph and/or record
Student’s image, likeness and voice while on the premises and to utilize any photographs, recordings
and/or other media (i.e. film/internet/audio recordings, etc.) in whatever form which may depict me for
any purpose including commercial use by the Owner, Owner’s sponsors and/or licensees for an unlimited
period of time. I understand and agree that I will not be compensated or receive additional consideration
for consenting to the use of my Likeness and that I will not be given a chance to receive, inspect or
approve the promotional or marketing material, messages and/or content that may use my Likeness I
hereby expressly waive and relinquish any moral rights in and any use of my Likeness. If I do not wish to
be photographed or filmed, I agree that I will expressly inform Owner of this fact in advance of
undertaking any activities on the premises.
II: ASSUMPTION OF RISK
In consideration of the use of the premises, facilities and/or instructional services provided by Owner, the
Student agrees as follows:
I, the Student, agree and acknowledge that I am fully aware that participation in Pilates or other classes
and activities at Pilates by Chelsea (hereinafter referred to as “Activity”) involve risks and I accept all the
risks of participating in such activities. I hereby agree and acknowledge that my use of the facilities,
equipment, appliances and premises, and services provided by Owner involve risks such as, but not
limited to, the RISK OF PROPERTY DAMAGE, BODILY INJURY, AND POSSIBLE DEATH. Student,
hereby, agrees and acknowledges that he/she is in proper physical condition to participate in the Activity,
and is aware that participation could, in some circumstances; result in physical injury or death. I
understand my physical limitations and I am sufficiently self-aware to stop physical activity before I
become ill or injured. If I am pregnant, or become pregnant, or am post-natal, my signature verifies that I
am participating in the Activity, with my doctor's full approval. I hereby, acknowledge that I have, of my
own free will, confidentially informed and made full disclosure to Owner of any pre-existing medical
conditions, prior injuries, mental or physical condition that could compromise my ability to safely engage
in activities at Pilates by Chelsea. I hereby, acknowledge that Owner has no training, ability or equipment
(i.e. Automated External Defibrillation (AED) devices or other equipment) available on the premises to
render emergency medical assistance and that in the event that I am injured during the course and scope
of my participation in activities on the premises, the sole remedy available will be Town of Colonie,
Albany County emergency medical services (i.e. “911”).
I, the Student, hereby, assume all risks seen and unseen, foreseeable and unforeseeable, that arise out of
Owner’s negligence, my use of the facilities, equipment, appliances and premises, my participation in
activities and instruction conducted on the premises, the acts of others and/or the unavailability of
emergency medical care or equipment. I hereby, agree, to accept the premises and conditions “as is”
including at the Owner’s discretion, placement of my mat in the practice room, temperature and humidity
levels within the practice room and facility, etc. I understand that at various points during my participation
in activities on the premises, I understand that Owner may place flower arrangements, play music and/or
burn incense, candles, wood or light the fireplace (or otherwise alter the temperature of the room) at his
sole discretion at various times in order to enhance the aesthetic environment and conditions of the
practice room and premises.
I, the Student hereby acknowledge that Pilates by Chelsea is a place of instruction in the practice of
Pilates and other forms of exercise —it is not a gymnasium, place of amusement or recreation— and that
I am coming to Pilates by Chelsea to receive instruction in Pilates and related aspects of that practice and
philosophy from Owner and/or Owner’s respective agents, heirs, assigns, contractors, guest instructors,
visiting instructors, employees, volunteers, interns, apprentices, student-instructors—whether paid or
unpaid—landlords, real properties, businesses and the Premises. I hereby expressly acknowledge that
there may be times when Owner is called to temporarily depart from the practice room or premises, but
that I am participating in Pilates pursuant to owner’s overall instruction and guidance at all times, whether
or not Owner is physically present in the practice room at any given moment of time.
SECTION III: OTHER
The Student agrees to pay for any or all classes, merchandise, and membership dues, as well as to
reimburse Owner for any damages to any property or indemnities caused by the Student negligently,
willfully, or otherwise. The Student enters into this agreement for himself/herself, his/her heirs, assigns
and legal representatives. If any provision of this agreement shall be unlawful, void or for any reason
unenforceable, then that provision shall be deemed severable from this agreement and shall not affect the
validity and enforceability of any remaining provisions. The Student has read and understands this
agreement and realizes it relates to surrendering valuable legal rights and does so freely and voluntarily.
In Purchasing or Attending any Class, Student has executed this Release as of the day and year of
payment for class. The signed waiver will be kept on file for each Student, and does not need to re-
signed each class.