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Welcome to
Little House Pilates!

Please complete this intake form to get started with us.

Emergency Contact Information

PILATES WAIVER AGREEMENT Why You’re Reading This Document Before you begin your first class with us, whether it is online or in person, we need you to clearly understand the risks of participating in our Pilates classes. The purpose of this release and waiver (the “Waiver”) is to communicate in an open and honest way the risks of practicing Pilates together and have you release Little House Pilates of any liability. Please be aware that if you do not sign this Waiver and agree to its terms, we will not let you participate in our Pilates classes. If you are under the Age of Majority in the State of California (18 years old), your legal guardian must also sign this Waiver on your behalf. PLEASE READ CAREFULLY, UNDERSTAND FULLY, AND ASK QUESTIONS IF ANYTHING IS UNCLEAR. WE ARE HERE TO SUPPORT YOU. MAKE SURE YOU UNDERSTAND THIS WAIVER. BY SIGNING THIS YOU AGREE YOU ARE SIGNING AWAY YOUR LEGAL RIGHTS AND YOU AGREE TO BE BOUND BY ALL THE TERMS OF THIS AGREEMENT. Parties. We will refer to Little House Pilates LLC, a Limited Liability Company registered in the State of California, as “Little House Pilates”, “us” or “we” and we’ll refer to you, the undersigned (electronically or by hand) or person who has clicked “I Agree” to this Waiver, as “you” or “your”. The Activities. You will be participating in Pilates classes at Little House Pilates. We offer personal and supportive Pilates including classes on the Pilates reformer, group Pilates classes and private Pilates sessions, which may involve but are not limited to the following activities (the “Activities”): Flexibility training in the form of Pilates positions, body weight exercises, use of Pilates equipment for stretching and resistance exercises, strength exercises, mobility, range of motion exercises, breathing exercises, and relaxation exercises. We may also use touch to facilitate proper mechanics and use exercises based on Pilates principles but which may not be codified as Pilates exercises. The constant in all of these classes is that the Activities involve moving in full ranges of motion, strength training, and postural training. The Activities may involve receiving adjustments from instructors, so please advise in advance if you do not want adjustments. The Activities also apply to any Pilates classes which are made available for online streaming and participation. As these classes will be taking place outside of Little House Pilates’s facilities, we need you to acknowledge that you are responsible for the safe facilitation of the Activities. To be crystal clear, we do not diagnose or treat diseases or any other conditions which may be acute or chronic. Pilates is not physiotherapy and we teach Pilates and do not offer physiotherapy services. Please let us know in advance if you have any questions about this. Equipment. In the course of the Activities, you will use a variety of equipment (the “Equipment”), which may include but is not limited to: straps, mats, reformer, chair, tower, rings, resistance bands, cadillac, barrels, dumbbells, foam rollers, massage balls. Please do not use any Equipment not instructed by Little House Pilates. Inherent Risks. You understand that participating in the Activities poses inherent risks, some more obvious/serious than others. These risks can result in serious harm and injuries that could change your quality of life and, in very rare and extreme circumstances, may even result in death. Injuries include but are not limited to things like muscle tears, strains and other musculoskeletal injuries, sprains, broken bones, cardiovascular complications, dehydration, dizziness and fainting. Exposure to and contraction of COVID-19 or other communicable diseases passed on via other participants and use of shared space or Equipment. There are additional risks posed by participating in the Activities online, as there is no in-person supervision or space provided for you, and you will therefore need to ensure the safety of the Activities, using your judgment how to best practice them, not pushing yourself too far or attempting anything you feel unsure how to perform. Affirmation of Health. By participating in any Activities at Little House Pilates, you affirm that you have sought medical advice or else are certain that your health and fitness levels are sufficient to participate in advanced level Pilates. COVID-19 / Infectious Disease. Amidst the current developments surrounding communicable diseases, you acknowledge that by participating in the Activities you are affirming that you are healthy and able to engage in practice and are not at an increased risk due to COVID-19 or other infectious diseases. If you are suffering from symptoms of a communicable disease or are unsure of your health and ability to practice the Activities, please consult with your doctor and we urge you not to visit our studio or participate in our Activities. We are all in this together and it is important that we follow guidelines on social distancing, hygiene practices, and act with kindness and responsibility towards each other in order to ensure everyone’s safety. Voluntary Assumption of Risk. You have read this Waiver and understand the risks of participating in the Activities with Little House Pilates. Your signature below, electronic signature or clicking 'I Agree’, and your participation in the classes at Little House Pilates illustrates your voluntary participation and assumption of the risks of the Activities. Release, Waiver and Indemnity. You hereby release Little House Pilates LLC, its members, directors, officers, contractors, employees, volunteers, agents, executors, administrators, successors, family members and assigns (the “Released Parties”) from any liability and damages arising from death or personal injuries, including the contraction of COVID-19 or other communicable diseases, however caused including as a result of Little House Pilates’s negligence, during your participation in the Activities at Little House Pilates. You are releasing the Released Parties at your own risk and you agree to forfeit any and all forms of legal recourse which may be available to you, including but not limited to any form of damages, as a result of your participation in the Activities. You agree that these provisions above apply to you, your family, heirs, executors or anyone else who may be able to bring a legal action on your behalf in the future. Media Release. We think you’re gorgeous and would love to show you off! By being a student at our studio, you agree to grant us the irrevocable right to use your image, likeness, photographs, video content, audio recordings of you captured in our studio or that you share with us online (via your own or others posting of you) as part of our online streaming, marketing and sales throughout the world and in perpetuity. You also release us from all claims you may have relating to the use mentioned in this section. Please let us know If you ever want us to stop using an image of you. If you would like to use any Little House Pilates materials, please ask us for permission beforehand. General Legal Provisions. Jurisdiction. This Waiver will be governed exclusively by the laws of the State of California. Severability. If any provisions of this Waiver are invalid or unenforceable, the other provisions in the Waiver will remain in full force and effect. Entire Agreement. This Waiver constitutes the entire agreement between the parties and replaces any prior agreements. Headings. The headings used in this Waiver are for stylistic purposes only and none of the content in the headings are intended to be legally binding. Online Agreement. We agree that this Agreement may be signed electronically or agreed to by having you click “I Agree”. Other Agreements: - I agree that I will be charged for cancellations with less than 24 hours notice for a private session and with less than 12 hours for a group class. - I agree that this amount is non-refundable and non-transferable. - I agree to the expiration dates of sessions or packages I purchase. - I understand that all private sessions are 50 minutes unless otherwise noted.

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