Release Form

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Additional comments

• If I am or will be pregnant during the course, I know that during and after pregnancy certain physiologic changes may occur in my body. I also understand that there is a low but inherent risk of vaginal bleeding, miscarriage, premature labor and premature birth with any pregnancy.
• I have voluntarily registered to participate in a personal training session or Tupler Technique® session or program with Bonnie Wayne of Diastasis & Ab Re-Pair, CPT and a professional licensed provider the Tupler Technique® Program. In order to participate in this program, I must understand and sign this informed consent.
• I accept full responsibility for participating in this program and agree to communicate any and all material physical discomforts or problems to my instructor. I accept all responsibility for my health and any resultant injury or mishap that may affect my well being while participating in the Tupler Technique® Program. In the event I suffer any injury or discomfort while participating in or resulting, directly or indirectly, from my participation in this program, I hereby waive any and all claims relating to such injury or discomfort against my instructor and any of their respective agents or affiliates.
• The workshop Content and information I learn from Diastasis & Ab Re-Pair and Bonnie Wayne will be used for my own personal health improvement, and will not be used by me to teach to others for monetary compensation/profit or personal gain.

By checking this box I am agreeing to the terms and conditions listed here, and is therefore a binding contract.