By signing below, I authorize Midnight Skies, LLC to charge the credit card provided herein.

GENERAL FITNESS WAIVER

THE ENERGY ANGEL, LLC

RELEASE FROM LIABILITY HOLD HARMLESS WAIVER

I also understand that my participation in fitness and/or any dance exercise fitness program thereof and any participation in fitness classes therein may involve risk, including, but not limited to, sprains, pulled muscles, aches and pains, and overall general soreness.  I also understand that any instruction provided is intended only to guide me in proper form and technique.  It is up to me to monitor my intensity levels and make my determination concerning the appropriate activity level based on my physical health. I understand that any questions concerning my ability to participate should be discussed with my physician.

I am in good health, and I have informed my doctor of starting this fitness program and have been cleared to participate.  I do not have any medical conditions, such as heart disease, asthma, hypertension, or diabetes, that may interfere with my use of the facility and participation in Fitness/Dance classes.

I have been advised to seek competent medical advice before I follow any exercise regimen or embark on a coached nutrition journey.

Based upon the foregoing and my desire to utilize this program/event/services, I hereby release The Energy Angel, LLC, Angela W Maske, the facility and instructors conducting the classes thereof, and assign from all liabilities and/or claims arising from, or in any way connected with, my use or participation of the program/facility or an extension thereof.  This has been fully explained to me.  I also understand that there will be no supervision of my workouts other than the instruction of the Fitness/Dance class instructor and that I assume the risk and responsibility of my fitness level and will adjust to fit my abilities accordingly.  I am participating in The Energy Angel Fitness/Dance/Nutrition programs of my own free will, with full knowledge of all it entails. I am responsible for my actions and the consequences of those actions.

The attendee grants The Energy Angel, LLC permission to use his/her likeness (including their minor children) in photography and/or video in all publications and materials without payment or consideration made to them.  The attendee realizes these photos and or/videos become the property of The Energy Angel, LLC, and will not be returned.  The attendee authorizes The Energy Angel, LLC to use, edit, copy, publish, or exhibit any photo or video for any lawful purpose.  The attendee waives the right to review any photo or video or to obtain royalties from the photo or video.  Please note:   Photos and videos will be taken throughout the event, and some photos/videos will be posted/published.

The comprehensive nutrition assessment & coaching plan included in this package must be initiated May 31, 2025.

Print Participant’s Name ________________________________________________________________

Signature of Participant’s Name _______________________________________Date _______________

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FOR MINORS UNDER 18:

PRINT NAME OF MINOR PARTICIPANT: _____________________________________________________

PRINT NAME OF PARENT, GUARDIAN OR AUTHORIZED PERSON:  ________________________________

RELATIONSHIP TO MINOR PARTICIPANT:  ___________________________________________________

SIGNATURE OF AUTHORIZED AGENT OF MINOR PARTICIPANT:  _________________________________

DATE: ______________