LIABILITY AGREEMENT FOR JANE C GODDEN @ JANIES POLE SCHOOL

I hereby certify that whilst attending exercise classes at Janies Pole School at whatever premises such classes may be held, I accept that if personal injuries occur, it is my own responsibility and not the liability of JC Godden.

PLEASE PRINT & FILL IN THIS FORM WHEN ATTENDING ANY OF OUR SERVICES!

Signed …………………………………………………….

Name …………………………………………………….

Address …………………………………………………….

Telephone …………………………………………………….

Date ……………………………………………………

JC Godden - Janies Pole School……………………………………………………