Living Well With Chronic Pain Classes

1. I certify that I am physically capable of participation in this activity/program.

2. I understand and confirm that I will choose the level of activity that will not harm me.

3. Further, I agree that in consideration for permission to participate in any Catholic Charities programs, I assume all risks of injury or illness incurred or suffered while on the premises where the program is being conducted.

4. RELEASE: In consideration of your accepting my application to participate in this or any wellness program, I hereby for myself, my heirs, executors, and administrators, waive and release any and all rights and claims for damages I may have against Catholic Charities of Southern MN, any program associated with Catholic Charities, the site where the program is conducted, their agents, representatives, employees, volunteers, class instructors and assigns for any and all injuries, illness or otherwise arising out of or in any way connected to my participation in this program.

5. Catholic Charities of Southern MN may partner with third-party health promotion programs, and as such may check my eligibility for these programs, leading to the submission of attendance dates.