PLEASE FILL IN NAME EMAIL AND DATE AND SUBMIT BEFORE CLASS - YOU WILL ONLY NEED TO SUBMIT ONCE TO KEEP ON FILE TO ATTEND VIRTUAL CLASSES Before taking online virtual classes or workshops with Kirsten Korot International, employees, instructors, independent contractors, all adult students and parents/guardians of kids under 18 must agree to the following Waiver and Release Agreement. Please complete the form at the bottom of this page to submit your electronic signature. Waiver and Release Agreement As the student taking classes or workshops at Kirsten Korot International with Kirsten Korot, employees, instructors and independent contractors, I understand that virtual classes may include physical movements and exertion. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in Kirsten Korot virtual classes, whether in-person or online. I represent and warrant that I am in good health and physical condition and I have no medical condition which would prevent my full participation in classes, whether in-person or online. In addition, I will make the instructor aware of any medical conditions or physical limitations before class. If I am pregnant, become pregnant or I am post-natal or post-surgical, my signature below verifies that I have my physician’s approval to participate. In consideration of being permitted to participate in classes, whether in-person or online, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the program. In further consideration of being permitted to participate in Kirsten Korot classes, whether in-person or online, I expressly irrevocably release and waive any claims that I have now or may have hereafter for any reason against Kirsten Korot International, its owners, employees, instructors and independent contractors, for injury or damages that I may sustain as a result of participating in a Kirsten Korot International class, whether in-person or online. Photos: I may be recorded or photographed while in the virtual or in person studio and these photographs may appear in Kirsten Korot International promotional materials unless otherwise specified. No person whose photograph is used will be identified by name, nor will any compensation be extended for such use.