Participant InformationName(Required) First Last Address(Required) Street Address City State / Province / Region ZIP / Postal Code Phone(Required)Email(Required) Best Contact Method(Required) Text Message, Voicemail or EmailLiability Release(Required) I have read and agree with the terms of the waiver statedI agree to release Grace Junek [DBA Be Inspired with Grace] and Powerhouse Fitness & Gym from any liability associated with my participation in this program. I recognize that any yoga or fitness activity requires physical exertion and carries the risk of injury. I understand that it is my responsibility to consult with a physician if I have any pre-existing conditions that may prohibit my full participation in these one-on-one sessions. Furthermore, this waiver is valid and covers all the sessions initially purchased.Discount Terms(Required) I agree Offer valid until 12/31/2024. All five-sessions must be booked and completed by 03/2025. One-time discount per person. 20% Off 5-Sessions with Grace:5-Sessions Quantity Price: $316.00 Quantity Total