Name

First Name

Last Name

Date Of Birth

MM

DD

YYYY

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Studio Phone

(###)

###

####

May I send you emails?

Yes

No

May I send you text messages?

Yes

No

Do you agree to photos and videos being taken you f you during the course?

Yes

No

Would you like to be tagged on social media?

Yes

No

Terms & Conditions

I take full responsibility for my actions at any and all times at HARA- beyond movement studio during any workouts, classes, practice and use of equipment in any way whilst engaged in activities in the studio, online or at a guest premises. I agree to keep my instructor updated as to any changes in my medical profile and that there shall be no liability on the instructor if I fail to do so. I agree that neither I, my heirs, assigns or legal representatives will sue or make any other claims of any kind whatsoever against HARA Beyond Movement Studio its employees or its members for any personal injury, property damage/loss, or wrongful death, whether caused by negligence or otherwise.

I Agree

Payment

I have paid Movimento Studio Sydney $700 Master Trainer fee on behalf for this course participation.

Date

MM

DD

YYYY