Cardio Dance 2024 Registration

I HEREBY, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily waive and release all rights and claims for damages or causes of action of any kind arising out of my participation in this Cardio Dancin’ program; and

I HEREBY release and forever discharge Joan Rutherford and The Mohawk Golf Club, Schenectady, NY 12309 and its owners, affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, from any physical injury that I may suffer as a direct result of my participation in this Cardio Dancin’ program.

Class Location: Mohawk Golf Club, 1849 Union Street, Schenectady, NY 12309.

Please bring your completed form and payment with you to the first class.
1.Did you read the above statement, and do you agree?(Required.)
2.What is your first name?(Required.)
3.What is your last name?(Required.)
4.What is your phone number?(Required.)
5.What is your mailing address?(Required.)
6.What is your date of birth?(Required.)
7.Please sign by writing your full name in the text box below(Required.)
Current Progress,
0 of 7 answered