COVID-19 Waiver

I acknowledge that the Novel Coronavirus/COVID-19 is highly contagious, and that many public health authorities, including, but not limited to the CDC, recommend social distancing and other measures to help prevent the spread of the virus.

I further acknowledge that Impact Pilates has put preventative measures in place to help reduce (but not eliminate) the potential for the virus to spread in all studio locations, and other, offsite locations, and that I will comply with all of Impact Pilates’ preventative measures.

I further acknowledge that, while Impact Pilates has put these measure in place to help reduce the risk of spread, there is no guarantee that the risk of exposure to the Novel Coronavirus/COVID-19 has been in any way reduced or eliminated, and that the risk of exposure to, or infection by the Novel Coronavirus/COVID-19 may result from the actions, omissions, and/or negligence of individuals entering the studio, including, but not limited to, myself, staff, other clients and guests of Impact Pilates, other clients, staff and guests at businesses other that Impact Pilates whom share the same building, cleaning staff, and other individuals and contractors who may enter the studio space from time to time. I understand the risk of potential exposure and/or infection to myself and others from entering the studio space, the building where the studio is located, and other locations where Impact Pilates may hold events or activities.

I further acknowledge that I am voluntarily seeking the services of Impact Pilates, and acknowledge that it is through my actions that I am increasing my risk to exposure to the Novel Coronavirus/COVID-19.

I further acknowledge that I will comply with all studio policies, and that I will notify staff immediately, followed up with written notice that I no longer am complying with any of the forgoing, and agree not to enter Impact Pilates studio space, the building it is located, or any offsite venues/locations where events or activities of Impact Pilates are being held.

I, for myself and on behalf of my family, spouse,
estate, heirs, executors, administrators, assigns, and personal representatives (collectively the “Releasors”), hereby forever release, waive, discharge, and covenant not to sue Impact Pilates, its board members, officers, agents, servants, independent contractors, affiliates, employees, successors, and assigns (collectively the “Released Parties”) from
any and all liability, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, or injury, including death, that may be sustained by the Releasors related to COVID-19 whether caused by the negligence of the Released Parties, any third-party while at the Impact Pilates, or otherwise, while participating in any activity while in, on, or around the Impact Pilates’ studio and/or while using any Impact Pilates’ facilities, equipment, or materials

I further agree to agree to indemnify, defend, and hold harmless the Released Parties from and against any and all costs, expenses, damages, claims, lawsuits, judgments, losses, and/or liabilities (including attorney fees) arising directly
or indirectly from or related to any and all claims made by or against any of the Released Parties due to bodily injury, death, loss of use, monetary loss, or any other injury from or related to my use of the Impact Pilates’ facilities, tools, equipment, or materials, whether caused by the negligence of the Released Parties or otherwise
specifically related to COVID-19.

I further acknowledge and agree that I will not enter Impact Pilates studio, the building the studio is located in, or any offsite venues/locations where events or activities of Impact Pilates are being held unless:

• I am not experiencing any symptoms of the Novel Coronavirus/COVID-19, including, but not limited to cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or loss of taste or smell.

• I have not travelled internationally within the last 14 days.

• I have not travelled to any state in the United States within the last 14 days, other than a “Lower-risk State,” as defined by the state of Massachusetts (see

• I have not completed the Massachusetts Travel Form, nor am I am required to complete the Massachusetts Travel Form (see

• I am not relying on an exemption (other than due to travel to a “Lower-risk State”) in order to not have to complete the Massachusetts Travel Form (see

• To the best of my knowledge, I have not been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19 within the last 14 days.

• I have not been diagnosed with the Novel Coronavirus/COVID-19 and have not yet been cleared as non-contagious by state or local public health authorities.