Participant Waiver Form
The Terra Class LLC – Participant Waiver and Release Form
Participant Name: ________________________________________________________
Date: ________________________
Class/Program/Event Title: ____________________________________________________
Acknowledgment and Assumption of Risk
I understand that movement-based, wellness, and educational classes, programs, workshops, events, videos, and related educational materials offered by The Terra Class LLC may include live in-person, live online, and prerecorded participation and may involve physical activity such as stretching, balance work, strength-based movement, breathwork, and mindful movement practices.
I acknowledge that participation in physical activity carries certain inherent risks, including but not limited to muscle strain, soreness, fatigue, loss of balance, falls, or other physical injury or discomforts.
I voluntarily choose to access or participate in classes, programs, workshops, events, videos, or other educational activities or materials offered by The Terra Class LLC and assume responsibility for the risks associated with my participation.
Online and Prerecorded Participation
When participating in live online or prerecorded programming offered by The Terra Class LLC, I understand that an instructor may not be physically present to observe or modify my movement.
I am responsible for choosing an appropriate and safe space for participation, using equipment safely, modifying or discontinuing movement as needed, and determining whether an activity is appropriate for me.
I agree to stop participating if I experience pain, dizziness, unusual shortness of breath, instability, or other concerning symptoms and to seek appropriate medical care when necessary.
No Medical or Therapeutic Relationship
I understand that the classes, programs, workshops, events, videos, and educational materials offered by The Terra Class LLC are provided for general wellness and educational purposes only.
These offerings and materials do not constitute physical therapy services, medical treatment, diagnosis, or individualized healthcare advice.
Participation in any class, program, workshop, event, video, or other educational activity offered by The Terra Class LLC does not create a physical therapy, patient–provider, therapist–client, or healthcare relationship between myself and The Terra Class LLC or any of its instructors.
If I have health concerns, a medical condition or injury, or questions about whether participation is appropriate for me during pregnancy, postpartum, or any other stage of life, I agree to consult my physician, midwife, physical therapist, or other qualified healthcare provider as appropriate before participating.
Baby/Child Presence (Optional)
Baby/Child Presence: If I choose to have a baby or child present during participation, I acknowledge that the baby/child is not a participant, and I assume full responsibility for the baby/child’s supervision and safety at all times. The Terra Class LLC is not responsible for any injury or harm to a baby/child present during participation. The Terra Class LLC may offer optional suggestions for incorporating a baby/child into certain movements (for example, holding a baby during a functional squat), but doing so is not required and is always the participant’s choice and responsibility. I am solely responsible for deciding whether it is appropriate to hold or incorporate a baby/child during movement and for maintaining a safe environment. If I choose to hold a baby/child during movement, I agree to move slowly, maintain stability, avoid movements that significantly challenge my balance, and discontinue the activity if I feel unstable or if the baby/child shows signs of distress. I take full responsibility of what is necessary in the moment.
Release of Liability
In consideration for being permitted to access or participate in The Terra Class LLC’s live in-person, live online, or prerecorded classes, programs, workshops, events, videos, and related materials, I hereby release, waive, and discharge The Terra Class LLC, its owners, instructors, contractors, agents, affiliates, partners, heirs, executors, administrators, and assigns from any and all claims, demands, damages, losses, or liabilities arising out of or related to my access to, participation in, or use of classes, programs, workshops, events, videos, or materials offered by The Terra Class LLC, including claims arising from ordinary negligence, to the fullest extent permitted by applicable law. This release applies to any injury, loss, or damage that may occur during or as a result of participation, whether caused by negligence or otherwise, to the fullest extent permitted by law.
Indemnification: I agree to indemnify, defend, and hold harmless The Terra Class LLC, its owners, instructors, contractors, affiliates, and partners from any and all claims, actions, suits, procedures, costs, expenses, damages, and liabilities, including attorney’s fees, brought as a result of my involvement in the class or event. I agree, to the fullest extent permitted by applicable law, to indemnify and hold harmless The Terra Class LLC, its owners, instructors, employees, independent contractors, agents, affiliates, and partners from claims, costs, expenses, damages, or liabilities arising from my conduct or participation in classes, programs, workshops, events, or other activities offered by The Terra Class LLC.
Media and Photography Consent (Optional and when applicable)
When photographs, audio recordings, or video recordings may be taken during a live in-person or live online class, workshop, or event, please indicate your preference:
Please check one:
■ I give permission for photographs or short video clips containing my image or likeness to be used by The Terra Class LLC for educational, promotional, or marketing purposes (including social media, website, or newsletters).
■ I do not consent to the use of my image or likeness in photos or videos for these purposes.
Emergency Contact Information — For Live Participation, When Applicable
Name: _______________________________________________
Phone: _______________________________________________
Severability: If any provision of this Agreement is found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.
Governing Law: This Agreement shall be governed by and construed in accordance with the laws of the Commonwealth of Massachusetts, without regard to its conflict of laws principles.
Binding Effect: This Agreement shall be binding upon and inure to the benefit of the parties hereto and their respective heirs, executors, administrators, legal representatives, successors, and assigns.
Participant Acknowledgment and Signature
By signing below or electronically accepting this Agreement, I confirm that I have read and fully understand this Participant Waiver and Release Form, and that I am agreeing to it freely and voluntarily. I acknowledge that I am participating voluntarily and at my own risk. I further confirm that I am at least 18 years of age.
Participant Signature: ____________________________________________________
Date:________________________
Participation in classes, programs, workshops, events, and other activities offered by The Terra Class LLC is voluntary and educational in nature. By registering for, purchasing access to, or participating in a class, program, workshop, event, or other activity offered by The Terra Class LLC, you agree to applicable Terra Class Refund, Community, and Accessibility Policies and understand that participation does not constitute individualized physical therapy or medical care.
The Terra Class LLC