top of page

Workshop Registration

Client Details

Workshop Date

Emergency Contact

Relation

Pre-Workshop Survey

How knowledgeable do you feel regarding labour, birth, newborn care, and infant feeding?

Waiver of Liability

I am participating in the Prenatal Education Workshop offered by Motherhood Matters Inc. I recognize that this workshop may require physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.


I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the workshop. I represent and warrant that I am physically fit and have no medical conditions that would prevent my full participation in the workshop.


In consideration of being permitted to participate in the workshop, I agree to assume full responsibility for any risks, injuries, or damages, known or unknown, which I might incur as a result of participating in the workshop, including any and all activities done with the workshop group, with Motherhood Matters Inc, or as an individual at the event venue contracted by Motherhood Matters Inc.


In further consideration of being permitted to participate in the workshop, I knowingly, voluntarily, and expressly waive any claim I may have against Sara Pridgen, Sam Sankey, Hanna Vanderhoef, Motherhood Matters, its staff, employees, or agents, for injury or damages that I amy sustain as a result of participated in the workshop. I, my heirs, and legal representatives forever release, waive, discharge, and covenant not to sue Sara Pridgen, Sam Sankey, or Motherhood Matters, its staff, employees, or agents for any injury or death caused by their negligence or other acts.


I, for myself and anyone entitled to act on my behalf, waive, release, and covenant not to sue Motherhood Matters Inc., the Pregnancy Care Centre, the venue and owners of said venue contracted by Motherhood Matters Inc., and any of its subsidiaries.

IMG_0412.JPG
IMG_0416.JPG
bottom of page