Caution: This is a release of legal rights. Read and understand it before signing.
References to Class or Seminar is to include all instructors, trainers, coaches, officials, employees, volunteers, students, agents, and assigns.
I ______________________________ (henceforth referred to as “student”), freely choose to participate in the class/semminar. In consideration of my participation in this class/Seminar, I agree as follows:
RISKS INVOLVED IN CLASS/SEMINAR: (Specific dangers endemic in this class/Seminar’s activity.) Inherent in any exercise class/Seminar is the risk of injury through improper use of equipment or imprudent exercise beyond your capability. I realize that utilizing equipment I am unfamiliar with could result in serious injury including death. I acknowledge and accept responsibility for any injuries incurred. I will immediately report any unusual signs or symptoms to the nearest instructor or next reasonable person.
HEALTH AND SAFETY: I have been advised to consult with a medical doctor with regard to my personal medical needs. I state that there are no health -related reasons or problems that preclude or restrict my participation in this class/Seminar. I have obtained the required immunizations, if any.
I recognize that this class/seminar is not obligated to attend to any of my medical or medication needs, and I assume all risk and responsibility therefore. In case of a medical emergency occurring during my participation in this class/seminar, I authorize in advance the representative of the class/seminar to secure whatever treatment is necessary, including the administration of an anesthetic and surgery. Class/seminar may (but is not obligated to) take any actions it considers to be warranted under the circumstances regarding my health and safety. Such actions do not create a special relationship between the class/seminar and me. I release the class/seminar, its instructors, trainers, coaches, officials, employees, volunteers, students, agents, and assigns from all liability for any bodily injury or damage I sustain as a result of any medical care that I receive resulting from my participation in the class/seminar, as well as any medical treatment decision or recommendation made by an agent of the class/seminar.
I agree to pay all expenses relating thereto and release the class/seminar from any liability for any actions.
I understand that the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms and still be highly contagious.
I confirm that I will not enter the training facility, take classes or seminars, or attend extra-curricular activities if I, or a member of my household, have been symptomatic (fever, shortness of breath, dry cough, sore throat, and/or fatigue) in the past 14 days.
I confirm I will not enter the training facility, take classes or seminars, or attend extra-currently activities for at least 30 days following 1) a positive COVID-19 test or 2) direct exposure to someone who has tested positive.
I release the class/seminar, its instructors, trainers, coaches, officials, employees, volunteers, students, and agents from all liability for any illness, including COVID-19 or complications arising from COVID-19.
I agree to pay all expenses and medical costs relating thereto.
ASSUMPTION OF RISK AND RELEASE OF LIABILITY: Knowing the risks described above, and in voluntary consideration of being permitted to participate in the Program, I agree to release and indemnify instructors, trainers, coaches, officials, employees, volunteers, students, agents, officers, and sponsors from and against any claim which I, the participant, my parents or legal guardian or any other person may have for any losses, damages or injuries arising out of or in connection with my participation in this Program.
MEDIA/PHOTO RELEASE: I authorize the class/seminar, and those acting within its authority, to, at no charge:
Record my participation, appearance or performance on video tape, audio tape, film, photograph or any other medium. Use my name, likeness, voice and biographical material in connection with these recordings. Copy the recording, in whole or in part and distribute it, including through podcasts on the Internet, solely for educational purposes by the class/seminar, and those acting under its authority, as they deem appropriate.
EMAIL SMS and MMS AUTHORIZATION: I understand that by signing below, I consent to receiving emails, text, and other media communications. I consent to receiving surveys, announcements and marketing materials by email, SMS and MMS. I understand that I can withdraw my consent at anytime and can unsubscribe if the content is no longer relevant.
SIGNATURE: I indicate that by my signature below that I have read the terms and conditions of participation and agree to abide by them. I have carefully read this Release Form and acknowledge that I understand it. No representation, statements, or inducements, oral or written, apart from the foregoing written statement, have been made. This Release Form shall be governed by the laws of the State of Arizona which shall be the forum for any lawsuits filed under or incident to this Release Form or to the Program. If any portion of this Release Form is
held invalid, the rest of the document shall continue in full force and effect.
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