Welcome to Helene Darmanin Physical Therapy, PC (d/b/a Mama Bear Physical Therapy)! This is a legal document. You are not required to sign it, but your participation in any of the Group Fitness Courses (as discussed in the next paragraph) is contingent upon you doing so. Please read this document carefully, sign, and ask us if you have any questions.

We offer three courses remotely: (1) general group fitness, (2) prenatal group fitness, and (3) postpartum group fitness (the “Group Fitness Courses”). The scope and nature of the activities offered in the Group Fitness Courses include but are not limited to bodyweight exercises, strength and flexibility exercises, breathwork, and pelvic floor awareness. You understand that your participation in the Group Fitness Courses may include some or all the activities mentioned above. These activities may cause you physical injuries or emotional distress. 

Policies for Group Fitness Courses

• Core Rules: Participating in any of the Group Fitness Courses remotely have the same core rules as if it were in-person. Please: (i) modify the exercises as needed, (ii) rest when necessary, and (iii) have something to hold onto or, if balance requires, modify the exercises to be done from a seated position. Please exercise either in sneakers or barefoot for safety and comfort and avoid exercising in just socks. 

• Camera on Policy: For safety, we ask that you keep your camera on during any Group Fitness Courses. However, if you have your camera off, you must have another person present with you while you participate for your safety.

• Questions: If you have questions, please get the instructor’s attention through video or send a message using the chat feature. Please ask questions whenever you have them. 

• Recording: You warrant and guarantee that you will not record, capture, screenshot, or otherwise engage in any electronic motion picture or photographic acquisition of any of the Group Fitness Courses. By signing this, you warrant that if those activities are recorded, you acknowledge and agree that we have no control of such recording and hold us harmless against any damages or claims arising out of such recording.

Remote Group Fitness Courses

We offer the Group Fitness Courses remotely. Remote technology platforms incorporate network and software security protocols to protect your confidentiality. Consistent with privacy laws, our technology includes safeguards intended to secure and ensure client information integrity. We utilize technology that: (i) complies with the relevant safety laws, rules, regulations, and codes for technology and technical safety for devices that interact with clients; and (ii) offers sufficient quality, size, resolution, and clarity such that we believe we can safely and effectively provide the Group Fitness Courses.

Although you are not receiving medical care from us, we work to comply with applicable state and federal laws, which may still require us to protect certain medical and personal information’s confidentiality and privacy. We have implemented policies to ensure our compliance with these requirements. 

• Benefits: Technology platforms can facilitate high-quality Group Fitness Courses conveniently and effectively.

• Risks: The risks may include, but are not limited to, the following: (i) information transmitted may not be sufficient (for example, poor resolution of images); (ii) technical deficiencies or failures; and (iii) your information could be interrupted, accessed, or intercepted.

• Alternatives: You can always choose not to participate in the Group Fitness Courses.

• Not Physical Therapy: Your participation in Group Fitness Courses may include some or all the activities mentioned above, and these activities may cause you physical injuries or emotional distress. Neither the Group Fitness Courses nor any other ancillary or related services, constitute physical therapy, as that term is defined under state law. 

Your Representations and Warranties

You represent and warrant that you: (i) understand your physical condition and capabilities; (ii) believe you are physically capable of safely participating in the Group Fitness Courses; and (iii) agree that you should immediately discontinue further participation in the Group Fitness Courses if you believe any condition to be unsafe. You also represent and warrant that within the three months preceding the dates of completion of this form: (i) you have no serious injuries and (ii) you have no injuries to your head, including concussions. If you experience any of these injuries in the future, you will immediately cease your program participation.

General Assumptions and Indemnification

If you feel unsafe or uncomfortable during the Group Fitness Courses, you agree to stop immediately. You alone are responsible for doing what is necessary to make yourself feel safe and comfortable, including leaving if necessary. You understand that you should inform us if you do not feel you can continue with the Group Fitness Courses. You are aware of the physical nature and possible risks of bodily injury including, permanent disability, paralysis, and death. You represent that you are physically capable of safely participating in the Group Fitness Courses.

We are not responsible for any injuries you sustain from participating in or attending the Group Fitness Courses. During the Group Fitness Courses, we may suggest or demonstrate an exercise, stretch, or technique. It is your sole responsibility to ascertain if such behavior is consistent with your ability and safe for you to perform.

You expressly waive any claim for any injury at any time related to your participation in or attendance at the Group Fitness Courses against us. As a condition of participation in the Group Fitness Courses, you agree to indemnify us against all claims, liabilities, losses, damages, suits, costs, and expenses, including reasonable attorney’s fees, relating to the Group Fitness Courses. You further agree to assume all risk of property damage, injury, and death associated with the Group Fitness Courses or your participation in or attendance at the Group Fitness Courses.

Agreement and Informed Consent

Your signature below confirms your understanding of and agreement to the below statements:

• Agreement to Terms: You have read and understand this entire document and agree to be bound by every part, have truthfully and to the best of your knowledge provided the information requested, and agree to update us of any changes to your health.

• Remote Technology: To participate in our Group Fitness Courses, you may be required to agree to the remote technology systems’ terms and conditions of use and informed consent for the use of those technologies.

• Informed Consent: You acknowledge and agree that you consent to participate in the Group Fitness Courses. 

Before you can participate, you must acknowledge and agree that you: (i) understand that none of the Group Fitness Courses are medical services, and none are intended to diagnose, cure, or treat any illness; (ii) assume all risk of participation in the Group Fitness Courses you selected; and (iii) will indemnify us for any loss, damage, or injury incurred during your participation in the Group Fitness Courses to the extent permitted under the law.

You, the undersigned, agree and acknowledge that you have not been given any guarantees about the outcome or benefits of the Group Fitness Courses.

You have been offered ample time and opportunity to discuss your concerns, and all your questions have been answered to your satisfaction. This document may be electronically signed. Electronic signatures are the same as handwritten signatures for the purposes of validity.