LIABILITY WAIVER

ORTHOSTRENGTH PHYSICAL THERAPY

WORKSHOP LIABILITY Waiver

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Please Type Workshop Location *

Are you a member of the Gym/Location hosting the workshop? Yes/No *

Please Type Workshop Date *

Our staff will be performing a workshop at gym listed above, where any athlete or client who wishes to participate. Following the workshop, we will provide each athlete/client with a few simple exercises and/or stretches to work on at home to reduce the risk of injury and to enhance performance, strength, and stability. The purpose of this workshop is not to diagnose or treat, while the screen will be performed by trained individuals, participation in the workshop carries with it a risk of injury that cannot be eliminated regardless of the care taken to avoid such injuries and the undersigned individual shall assume all risk by participating in the workshop. By signing below, and in consideration for the aforementioned workshop, I do waive and forever release any and all rights and claims for any damages and liabilities of any kind arising out of my participation in this workshop, against all persons, entities, and agencies involved with performing the workshops, include but not limited to: location listed above, Orthostrength Physical Therapy, and any other related individuals or entities. I understand that this workshop is not intended to diagnose or treat any injuries, but to assist with optimizing movement for the athlete/client. I also understand that my participation in this workshop is not a guarantee of injury prevention or performance. The results will not be shared with any individuals or entities except as outlined herein and will only be used for informational purposes including tracking of injuries and/or trends. I also agree to being contacted by Orthostrength Physical Therapy in the future. We will not share your personal information here onto per Orthostrength Physical Therapy’s Privacy Policy. I have carefully read this waiver of liability and understand that I am giving up legal rights, including my right to sue. I acknowledge that I am signing this waiver freely and voluntarily and intended by my signature to be a complete and unconditional release of all liability to the extent allowed by law.

I have read the waiver above and agree *

Yes

Type Full Name As Electronic Signature *

Submit

ORTHOSTRENGTH PHYSICAL THERAPY

WORKSHOP LIABILITY Waiver

Location

HOURS OF OPERATION

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SCHEDULE A CONSULT

ORTHOSTRENGTH PHYSICAL THERAPY​​WORKSHOP LIABILITY Waiver

Location

HOURS OF OPERATION

Contact Us

SCHEDULE A CONSULT

ORTHOSTRENGTH PHYSICAL THERAPY

WORKSHOP LIABILITY Waiver