Checkbox Items * Informed Consent and Waiver. Acknowledgement of Purchase I through the purchase of training sessions, have agreed to participate voluntarily in a program of physical exercise, including, but not limited to, strength training, aerobic exercise and flexibility development, or in the VF Dance Theater program of dance/theater activities ( together, “Activities”), under the guidance of VF Dance & Fitness, LLC, t/a Group X Athletics and t/a VF Dance Theater, its instructors and personal trainers (together, “Trainer”). Acknowledgement of Health I declare myself physically and mentally sound and suffering from no condition, impairment, disease, infirmity or other illness that would prevent my participation in training sessions or my use of Equipment (as defined below). I acknowledge I have been informed of the need for a physician’s approval for my participation in an exercise/fitness activity or in the use of Equipment or any Activities. I recognize it is my sole responsibility to obtain an examination by a physician prior to involvement in any exercise program. I acknowledge I have either had a physical examination and been given my physician’s permission to participate, or if I have chosen not to obtain a physician’s permission prior to beginning this exercise program or any Activities with Trainer, I acknowledge I am doing so at my own risk. Equipment Trainer or I will provide the equipment or machinery to be used in connection with workouts, including, but not limited to, benches, dumbbells, barbells, and similar items (“Equipment”). I represent and warrant that any and all Equipment I provide for training sessions (“My Equipment”) is for personal use only. Trainer has not inspected My Equipment and has no knowledge of its condition. I understand I take sole responsibility for My Equipment. I acknowledge that although Trainer takes precautions to maintain the Equipment provided by Trainer (“Her Equipment”), Her Equipment and/or My Equipment (“Her or My Equipment”) may malfunction and/or cause Injuries and Changes (as defined below) and that I take sole responsibility to inspect any and all of Her or My Equipment. Assumption of Risk I understand and am aware that Activities, including the use of Equipment, are potentially hazardous activities. I acknowledge the possibility of injuries and physical and mental changes arising during and/or resulting from engaging in Activities does exist. Injuries and changes include, but are not limited to, abnormal blood pressure, fainting, disorders in heartbeat, heart attack, mental changes, other injuries or conditions, permanent disability, paralysis or death (together, “Injuries”). I understand Injuries could result in my becoming partially or totally disabled and incapable of performing any gainful employment or having a normal social life. I understand the risks associated with the Activities may be caused by my own actions or inactions, the actions or inactions of others participating in the Activities, the condition of the Equipment, mats or other circumstances in which the Activities take place or the NEGLIGENCE OF THE RELEASEES NAMED BELOW. I am voluntarily participating in Activities and using Equipment with knowledge of the dangers involved. I understand and take sole responsibility for any and all Injuries that may occur to myself and/or others, including but not limited to Trainer, related to any and all Activities associated with Trainer’s instruction, even if not specifically set forth in this document, whether or not they fall within the scope of reasonably foreseeable injuries related to such Activities and whether or not undertaken in Trainer’s presence. Although Trainer will take precautions to ensure my safety, I expressly assume and accept sole responsibility for my safety and for any and all Injuries that may occur. Waiver and Release of Liability In consideration of my participation in the Activities, I hereby release and agree to hold harmless Trainer, its respective members, directors, agents, representatives, assigns, employees, instructors, choreographers, volunteers, other participants, and owners and lessees of the premises on which the Activities take place (each considered one of the “RELEASEES” herein) from any and all liability, Informed Consent and Waiver VF Dance & Fitness, LLC Informed Consent and Waiver Form Page 2 of 2 claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected to my participation in any and all Activities, use of Equipment, or any and all acts or omissions, including negligence by any RELEASEE, including negligent rescue operations, or caused by any other reason. This waiver and release of liability includes, but is not limited to: (a) Injuries to myself or my property that may occur as a result of (i) Equipment that may malfunction or break; (ii) any and all defects, latent or apparent, in the design or condition of Equipment; (iii) any and all slips, falls, or dropping of Equipment; (iv) any and all improper maintenance of Equipment or facilities; (v) any hazardous condition that may exist on the premises, including, but not limited to, the specific workout area; and (vi) Trainer’s negligent instruction or supervision; and (b) damage to property, including but not limited to, Equipment and the premises. COVID-19 Assumption of Risk, Release and Indemnification I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 while engaging in the Activities and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 or related illness may result from the actions, omissions, or negligence of Trainer, myself or others. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, attorney’s fees, or expense, of any kind, whether or not related to COVID-19, that I may experience or incur in connection with the Activities (“Claims”). By signing this Agreement, I hereby release, covenant not to sue, discharge, hold harmless, defend, and indemnify the RELEASEES, of and from any and all Claims, that I, or anyone on my behalf, makes against any of the RELEASEES. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Trainer and its representatives. Conclusion I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from this program. I understand results are individual and may vary. I acknowledge I have thoroughly read this waiver and release and fully understand it is a waiver and release of liability. By signing this document, I am waiving any right I, or my heirs and/or assigns, may have to bring any and all legal actions or to assert any and all claims against the RELEASEES. I represent and warrant I am signing this agreement freely and willfully and not under fraud or duress. I further represent and warrant no social relationship exists between Trainer and me, or if such a social relationship exists, for purposes of my training sessions, Trainer and I have assumed a strictly business relationship, and I understand any social relationship does not render this waiver invalid. These exculpatory clauses are intended to apply to any and all Activities occurring during the time for which I have contracted with Trainer.
