Please read and complete:

I, the undersigned, hereby expressly and affirmatively state that I wish to participate in an exercise program led by KK Pinkowski and/or Charm School Fitness.  I realize that my participation in this activity involves risk of injury, including but not limited to muscle strain, joint sprains, broken bones, slips, trips, falls, heart attack, stroke, and even the possibility of death.  I also recognize that there are many other risks of injury including serious disabling injuries, which may arise due to my participation in this activity and that it is not possible to specifically list each and every possible injury risk.  However, knowing the material risks and appreciating, knowing, and reasonably anticipating that other injuries and even death are a possibility, I hereby expressly assume all of the risks of injury and even the risk of death which could occur by reason of my participation.  I understand the risk of my participation in this activity and knowing and appreciating the risks I am voluntarily choosing to participate.  I do hereby waive, release and forever discharge KK Pinkowski, Charm School Fitness, and all employees, representatives, and all others from any and all responsibilities or liability for injuries or damages resulting from my participation in this activity. 


I have read and I understand and agree to the foregoing waiver and I acknowledge that by submitting this form, my name typewritten below shall be in lieu of my handwritten signature but shall be of the same force and effect as though I had signed the same in ink.