Consent for Participation / Informed Consent Waiver

Neurowerks offers a specialized intensive exercise program designed for individuals, including children and adults, with developmental, neurological, sensory, orthopedic, and various disabilities. Our team at Neurowerks consists of physical therapists, physical therapist assistants, and personal trainers. The studio is owned and operated by Neurowerks LLC & Neurowerks FIT LLC.

Engaging in any physical activity, intense exercise program, or using exercise equipment (including the TheraSuit, the Universal Exercise Unit, and Pilates equipment) inherently involves some level of risk. While the use of safety equipment, adequate supervision, and skilled trainers significantly diminishes the risk, the potential for injury during participation in the center’s activities still exists.

Therefore, it is necessary to seek your permission:

As the parent/guardian, I further understand that any therapy or training is voluntary, and any participant has the right to decline or discontinue any services provided by Neurowerks. I grant permission for the individual under my care to take part in the exercise program offered by Neurowerks LLC & Neurowerks FIT LLC (Owners & Employees). I release them from any liability, claims, demands, or causes of action, both current and future, arising from pain or injury, regardless of the cause, that may occur during or after my child’s or my participation in the exercise/training program session.

I acknowledge that Neurowerks functions as a training facility, which offers Physical Therapy, through a licensed trained individual, and on occasion an additional licensed therapists along with personal trainers.  These licensed therapists and personal trainers may observe, handle, or have access to my child’s medical information.

I grant Neurowerks permission to use photographs and videos taken of either myself or my minor child during exercise sessions for educational, informational, and promotional purposes, including on the website, Facebook, and Instagram.

Thank You!

Neurowerks team thanks you for filling out the Form. We will get back with you soon.