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Please read Pole in the Park Rules before filling out the waiver.
Please read this over carefully and sign below only if you agree to all terms
Pole dance is rough on your body physically. Bruising, skin burns, muscle pains and aches are all a normal experience, and will get better over time. Falling can cause an aray of bodily harm, from strains, sprains, or broken limbs, concusions, and other injuries. Please be aware of the risks that come with pole dancing before starting. By completing this waiver you understand and assume all risks, including unseen risks, and acknowledge that Pole Des Moines, LLC and it's instructors are not liable for any injuries or property damage.
I am 18 years or older.
Yes, subscribe me to your newsletter.
I understand that if a Medical Emergency were to happen with any of the person or persons attending leading to them becoming incapacitated or unconcious, the instructor is instructed to call Emergency services and then your Emergency Contact. Medical Emergencies can include, but are not limited to; fainting, seizures, broken bones, stroke, heart attacks, etc. This is for everyone's safety.
I understand that if a medial emergency were to happen to you or to an additional student, the instructor is instructed to call Medical Services then your Emergency Contact. This is for your safety.**
Any and all medical costs that incur during or after the session is solely your responsibility. Pole Des Moines, LLC is not liable or responsible for reimbursment of any Medical costs that incurred in a medical emergency before, during or after the booked session.
I agree and understand that any medical costs that incurred before, during or after the booked session, are solely my responsibility and Pole Des Moines, LLC is not liable for any reimbursement towards any costs accumulated.*
I understand I am liable and responsible for any and all injuries and medical costs to myself, additional students or the minor listed above.*
By signing and checking below, you are agreeing to be held liable for any damages done to any equipment provided by Pole Des Moines, LLC. You agree to be responsible to reimburse all charges relating to damages, or legal fees that incurred during or after the booked session. You understand you are responsible for all guests, animals, children, and additonal students that you bring to the event.
I agree to be held liable and will be responsible for reimbursement for all charges due to damages or thefts done to any equipment provided under Pole Des Moines, LLC.*
I assume all responsibility for reimbursements for any legal feels that incur for myself and for Pole Des Moines, LLC.*
I understand I am responsible for any other adults, children and animals that I bring.*
By signing this document, I acknowledge the inherent risks and voluntarily assume full responsibility for any injury, damage, or loss that may result from my participation. I hereby waive and release the business, its owners, and its staff from any and all liability, past, present, and future, relating to the services provided.
I understand that I am fully responsible for myself and my physical wellbeing while using any and all equipment provided by Pole Des Moines, LLC and other equipment donated for use under Pole Des Moines, LLC.*
I understand and acknowledge Pole Des Moines, LLC will not be held liable for any injuries that may occur while using any equipment provided by or to Pole Des Moines, LLC. *
I assume all responsibility for all costs of medical and legal fees that may incur during or after the time used on the equipment owned by Pole Des Moines, LLC. I understand Pole Des Moines, LLC will not be held liable for any reimbursements for any legal or medical fees during and after using listed equipment.*
I understand that everyone with good intentions is welcome to participate, but may be asked to leave for any reason.*
I acknowledge that I have read the rules posted by Pole Des Moines, LLC. I understand that any damages sustained to equipment due to improper use may result in paying for said damages. I understand that all rules must be followed, and that I may be asked to leave if I do not adhere to them.*
