Penn Community Bank Pre Registration

Penn Community Bank Wellness Fair Group CLass

* Indicates required field

Name *

First

Last

Liability Waiver: Please read and accept ____________________________________ I, the undersigned, being aware of my own health and physical condition, and having knowledge that my participation in any exercise program may be injurious to my health, am voluntarily participating in physical activity with GetReal Training,LLC. ____________________________________ Having such knowledge, I hereby release GetReal Training,LLC., their coaches, representatives, agents, and successors from liability for accidental injury or illness which I may incur as a result of participating in the said physical activity. I hereby assume all risks connected therewith and consent to participate in said program. _____________________________________ I agree to disclose any physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in said fitness program. *

I Accept and am over 18 I Accept and am under 18 (Parent / Guardian signature required) __________________________________________ Please add me to your E-mail list for all things GetReal Training!

Signature (Parent/Guardian required if under 18) *

Email *

( Please Register Me Now )