This Release, Waiver and Hold Harmless Agreement is made by and between the undersigned and Virginia Orthopaedic Manual Physical Therapy Institute (VOMPTI), LLC, and entered into on the day month and year below. The parties to this agreement recognize that participation in this course could lead to physical injury and he/she assumes such risk occurring during or after the participation in this class.

I have enrolled in an educational/manual physical therapy course given by VOMPTI, LLC. I hereby affirm that I have and will keep VOMPTI, LLC fully informed of any existing physical condition or disability which would prevent or limit my participation in this course. I will also keep VOMPTI, LLC informed of any physical condition or disability arising from my participation in the class. In consideration of my participation in VOMPTI, LLC’s course, I, my heirs and assigns, herby release VOMPTI, LLC (its employees and owners), from any claims, demands and causes of action arising from my participation in this course. I hereby affirm that I have read and fully understand the above.  I agree to the above terms.

Individuals who find it necessary to cancel may receive a refund, less a 15% processing fee. To receive a refund you must submit written notification at least 7 days before the course date.  The entire course fee may be transferred to another VOMPTI sponsored course for that same calendar year, or as approved by the VOMPTI Director.  The course sponsor reserves the ability to cancel the course within 15 days or in the event of circumstances beyond our control and assumes no responsibility for expenses incurred by participants. In the event of cancellation, a full tuition refund will be provided.