Training with Mandy, LLC

This Liability Waiver and Informed Consent Agreement (“Agreement”) is entered into on the date signed below by and between Mandy Dieter, Training With Mandy, LLC and client signed below.

Question Title

* 1. Name

Question Title

* 2. Acknowledgements:

Question Title

* 3. I consent to the use of my photographs given the acknowledgements above:

Question Title

* 4. Signature:

Question Title

* 5. I acknowledge that by entering my name above I am providing a digital signature.

Question Title

* 6. Date

Date

T