Warning: Undefined variable $groupname in /home1/bloominp/public_html/bloominplace-info/GAP/signup_web.php on line 159

BAiP Online Signup


Warning: Undefined variable $groupname in /home1/bloominp/public_html/bloominplace-info/GAP/signup_web.php on line 164

*** = indicates required information
First Name ***
Last Name ***
Phone # ***
Email Address (please check carefully) ***

Releases for BAiP Exercise and Sports Program (please acknowledge and accept by clicking the circle at right)

I understand that I am required to sign this Waiver and Release of Liability ( 'Waiver') in order to participate in any offering of the Bloomingdale Aging in Place ( 'BAiP') Exercise and Sports Program, including but not limited to chair yoga, gentle yoga, Pilates, MOVEMENT SPEAKSĀ®, softball, tennis and hiking. This Waiver covers participation in both in-person and remote BAiP Exercise and Sports Program classes.

I understand that the BAiP Exercise and Sports Program involves physical activity that may pose certain risks to me. I recognize that the program requires physical exertion that may be strenuous at times and may cause physical injury and I am fully aware of the risks and hazards involved. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the Exercise and Sports Program. I represent and warrant that I have no medical condition that would prevent my participation.

I agree to assume full responsibility for any risks, injuries or damages known or unknown which I might incur as a result of participating in the Exercise and Sports Program. By signing this Waiver, I knowingly, voluntarily and expressly release the instructor of this class as well as BAiP (including their respective directors, officers, committee leaders, agents and employees) from any and all claims that I may have for injuries or damages received or incurred in connection with my participation in this activity, whether arising during the course of the activity or thereafter.

I understand and agree that I will be responsible for my own transportation to any in-person event and assume full responsibility for any risks, injuries or damages known or unknown which I might incur as a result of traveling to or from a BAiP in-person event.

I have read the above Waiver, understand its contents and voluntarily agree to its terms and conditions.

***     Yes, I acknowledge and accept, and checking this circle serves as my signature on this waiver

or Cancel