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.

Question Title

* 1. Did you read the above statement, and do you agree?

Yes

Question Title

* 2. What is your first name?

Cardio Dance 2024 Registration

Question Title

* 1. Did you read the above statement, and do you agree?

Question Title

* 2. What is your first name?

Question Title

* 3. What is your last name?

Question Title

* 4. What is your phone number?

Question Title

* 5. What is your mailing address?

Question Title

* 6. What is your date of birth?

Question Title

* 7. Please sign by writing your full name in the text box below