Health History, Policy and Waiver

By providing an e-signature below, I acknowledge the following:

I have enrolled in one or more well-being programs with Connected. Movement in Sync.  I am advised and I understand that participating in one or more well-being programs including those which may include physical activity or exercise or movement present some unavoidable risk of injury, especially to those who have pre-existing injuries, illness or medical conditions.  I understand that the use of exercise equipment also carries with it the risk of injury.  I recognize that many changes may occur as a result of the sessions including possible short-term aggravation of some symptoms, feelings of tiredness, light-headedness, muscle soreness, mood changes, etc.

I also understand that a medical evaluation is advisable before commencing programs of physical activity or exercise or movement.  Anne Lloyd Willett, Connected. Movement in sync is not engaged in diagnosing or treating medical diseases or deficiencies. 

 

I expressly assume all risks of my participation in one or more well-being sessions conducted by Anne Lloyd Willett, Connected. Movement in Sync including risk of injuries resulting from or relating to my participation in one or more well-being programs.

Connected. Movement in Sync requires 24-hour notice of cancellation for scheduled private sessions.  If an appointment is cancelled within 24 hours, payment will be applied.

Thank you!