Studio3 COVID Waiver, Liability Form & Questionnaire

    I acknowledge that by booking appointment(s) with the intent to participate in person in a Pilates or Yoga session/class at Studio3 that prior to each pre-booked session I have not:

    1. Been in close physical contact with a person experiencing symptoms of COVID-19 such as shortness of breath, dry cough, fever, flu-like symptoms and other symptoms associated with COVID-19 within the past 14 days.
    2. Been in contact with anyone who has tested positive for COVID-19 in the last 14 days.

      I acknowledge that I am fully vaccinated with one of the Health Canada approved Covid-19 vaccines.

    Please upload a copy of your second vaccine documentation here*:

    I confirm that I am not experiencing any of the symptoms of COVID-19 and will immediately notify STUDIO TO THE POWER OF 3, INC. of any changes in my personal health.

    By attending my pre-booked appointments at Studio3 I waive any right to claim against the company STUDIO TO THE POWER OF 3, INC. for any bodily injury, loss or damages as a result to any exposure to COVID-19.

    *Our Studio mail server is hosted on an SSL-compliant Web server which means any information you send to us is transmitted securely via an encrypted connection between your computer/device and our server. We will not save or download any certificates but instead update your studio accounts with a recognizable code that indicates we are in receipt of your document.

    Liability Release

    I subscribe to and accept the following:

    * Indicates mandatory field

    I agree that Studio to the Power of 3 Inc. shall not be liable for any damages arising from any personal injuries sustained by a guest or a client on or about the premises of Studio to the Power of 3 Inc. or by participation in a Studio to the Power of 3 Inc, virtual (online) event such as group classes, private training, workshops, seminars and other hosted engagements.
    I AGREE*

    As a guest or a client, in attending Studio to the Power of 3 Inc. and using its facilities and equipment, I do so at my own risk. I assume full responsibility for any injuries or damages which may occur when using said facilities. I also acknowledge that my voluntary enrolment and participation in virtual (online) Studio to the Power of 3 Inc group classes and other hosted engagements is done solely at my own risk and I accept full responsibility for any injuries or damages which may occur while participating in the hosted engagement.
    I AGREE*

    I do hereby fully and forever release and discharge Studio to the Power of 3 Inc. its owners, contractors, and agents from any and all claims demands, damages, rights of action, or cause of actions, present or future, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of my use or intended use of Studio to the Power of 3 Inc. facilities and equipment and participation in it's virtual (online) hosted engagements.
    I AGREE*

    I warrant, represent and agree that I am in good physical condition and have no disability, impairment, or ailment preventing me from engaging in active or passive exercise, or any such condition that will be detrimental or inimical to my health, safety, comfort, or physical condition if I do so engage or participate.
    I AGREE*

    Studio to the Power of 3 Inc. shall not be liable for the loss of theft of, or damages to, the personal property of a guest or a client.
    I AGREE*

    Terms and conditions of sessions:

    I understand that 24 hours notice for any changes or cancellation is required. I will be billed for any session in full if 24 hours notice is not given directly to my instructor.
    I AGREE*

    All prepaid sessions are fully transferable but not refundable. New packages must be paid in full the day of first session.
    I AGREE*

    All packages expire after 6 months & will not be refundable.
    I AGREE*

    I understand that under certain circumstances, written medical clearance may be requested prior to commencing or continuing with a program.
    I AGREE*

    Name*

    Date*

    Email*

    Birthdate*

    Address*

    City*

    Province/State*

    Postal/ Zip Code*

    Emergency Contact
    Name*


    Phone*

    Best phone number to reach me at:*

    By entering my name electronically I acknowledge the above statements to be true:*


    Please list any injuries and the approximate date that it occurred (old & new)

    Please list any illness and/or medications that may impact your level of physical exertion and that STUDIO3 should be made aware of:

    Please list your current workout/physical activities:

    Please list your fitness goals and what you’re hoping to gain by adding a Studio3 workout into your routine:

    How did you hear about us?

    Would you like to be added to our electronic newsletter mailing list that is sent out periodically to inform clients of promotions, group classes and other events at Studio3
    YESNO