Pure Barre Story Questionnaire

Tell us about yourself and your Pure Barre journey. *

What do you love most about Pure Barre? *

What changes have you seen in yourself as a result of Pure Barre? *

What advice would you give to someone just considering Pure Barre? *

Which Pure Barre studio do you visit most often? *

To have your story featured on our blog, please submit a photo of you behind your studio's desk with the Pure Barre logo or in the studio with a Pure Barre ball.

Please share a high res photo

Full Name *

First Name Last Name

E-mail *

Address *

City *

State *

Zip Code *

Birth Date

Month Day Year

Please list your social media handles and website/blog address if applicable.

I agree to the terms and conditions. *

I understand and acknowledge the following: (1) I certify that I am at least 18 years of age and am a U.S. resident. (2) That I, on behalf of myself and my heirs, executors, trustees, guardians ad litem, legatees, and administrators do hereby accept the invitation to participate in the “Pure Barre® Fan of the Week” promotion. (3) For value that I acknowledge that I have received, I irrevocably hereby grant the unqualified right and hereby authorize PB Holdco, LLC and PB Franchising, LLC (the “Grantees”), its and their officers, directors, agents, parents, subsidiaries, affiliates, employees, shareholders, managers, members, insurance carriers, advertising or promotion agencies, its franchisees and their owners and employees/contractors, and anyone acting under the authority or permission of said Grantees, the unrestricted, absolute, perpetual, worldwide right and license to use my name, address, photograph, likeness, voice, biographical and personal background information, statements, and, without limitation, any notes, photograph, film, or video or audio tape that may be taken of me or of such materials (the foregoing, collectively, the “Content”), without further compensation, consideration, or notice or permission to me or to any third party, and to reproduce, copy, modify, create derivative works of, display, perform, exhibit, distribute, transmit or broadcast, publicly or otherwise, or otherwise use and permit to be used the Content or any part thereof, whether alone or in combination with other materials (including but not limited to text, data, images, photographs, illustrations, and graphics, video or audio segments of any nature), in any media or embodiment now known or hereafter developed (including but not limited to any format of any computer-based, Internet-based, electronic, magnetic, digital, laser or optical-based media), in connection with Grantees’, or their designee’s, advertising, promotion, publicity, trade, sweepstakes or sweepstakes promotions, activities, or materials in connection with the Pure Barre mark. (4) I further waive all right of inspection or approval and irrevocably release Grantees and each person herein named of and from any and all liability, claims and/or demands, for known injuries or damages, including but not limited to all manner of action and actions, causes and causes of action, claims for relief, suits, debts, sums of money, controversies, judgements and executions which I, or my heirs, executors, administrators, successors, assigns or legatees can, shall or may have, for, upon or by reason of the publication, use or distribution, of such photographs or my name as herein authorized. This paragraph is meant to include, but is not limited by, those rights and remedies afforded under California Civil Code Sec. 3344 et seq. and New York Civil Rights Law Sec. 50 et seq. and any other similar statute, ordinance, regulation or law of those or any other jurisdictions. (5) I warrant that I have the right and am free to authorize Grantees to use the Content and I hereby grant such authorization. I further warrant that the use of the Content by Grantees will not violate the rights of any other party. (6) By checking the above box, I acknowledge that I have read this “Waiver and Release Agreement” and am aware of the legal consequences of signing this document.

SHARE YOUR PURE BARRE STORY