Sunday, May 15, 2011   PMT Dance Studio - Chelsea map   2:30 p.m. - 4:30 p.m. Home       About       Register       Survey       Contact

REGISTRATION   Space is limited and these workshops fill up fast!   Before May 1 After May 1 $25 $35 Register Now! Registration   First Name Last Name Email Phone Address City State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip      Date of Birth      Gender Female Male      What is your current workout routine?      When was your last consistent workout?      What are your fitness goals?      How often do you eat fresh fruits and vegetables? Every Day Frequently Sometimes Rarely      Please describe your energy level. Very Energetic Energetic Somewhat Energetic Low Energy      Please describe your level of stress. High Stress Some Stress Little Stress No Stress      Tell us what you ate for breakfast, lunch and dinner yesterday.      Release & Waiver of Liability   In consideration for being permitted to participate in personal training sessions, fitness classes, programs or workshops (collectively, the ‘Activity’) offered by Cindy Lai, Molly Lee, Cindy Lai Fitness, and/or Energizing Nutrition (‘Slim & Trim Workshop’), as well as the benefits that I will derive from my participation in the Activity, I hereby represent and agree as follows: 1. Representations. (a) I am physically fit and able to participate in the Activity, and I have no medical condition that would prevent my participation in the Activity; (b) I understand that it is my responsibility to consult with a physician regarding my participation in the Activity; (c) I acknowledge that I have had the opportunity to ask Cindy Lai Fitness any questions that I may have about the Activity that I believe are necessary in order to decide whether I am able to participate in the Activity and make the above representations. 2. Assumption of Risk. I acknowledge that my participation in the Activity carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. I understand that the specific risks can, and do, vary from one activity to another and that these risks range from minor injuries to catastrophic injuries, including paralysis and death. 3. Release of Liability. I, on behalf of myself, heirs, successor, assigns, personal or legal representatives and estate hereby forever release, waive, discharge and covenant not to sue Slim & Trim Workshop from any and all liability from all claims, actions, suits or other proceedings resulting in any injury, death, accident, illness or property damage that I may suffer or sustain, regardless of fault, arising from or in connection with, my participation in the Activity. 4. Indemnification. I hereby voluntarily release, forever discharge and agree to indemnify, defend and hold harmless Slim & Trim Workshop from and against any and all claims, actions, suits, proceedings, costs, expenses, damages and liabilities brought as a result of my participation in the Activity and the building or facilities where the Activity occurred and to reimburse Slim & Trim Workshop in full for any such expenses incurred. 5. Slim & Trim Workshop reserves the right to use any photograph taken of you relating to the Activity in promotional materials, brochures, blogs and websites.      I have read the above release and waiver of liability and fully understand its content. I voluntarily agree to the terms and conditions stated above.

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