WAIVER AND RELEASE OF LIABILITY
THIS FORM IS AN IMPORTANT LEGAL DOCUMENT. IT EXPLAINS THE RISKS YOU ARE ASSUMING BY PARTICIPATING IN A FITNESS AND NUTRITION COACHING PROGRAM. IT IS CRITICAL THAT YOU READ AND UNDERSTAND THIS WAIVER AND RELEASE IN ITS ENTIRETY.
RELEASE OF LIABILITY FOR RECEIPT OF FITNESS AND NUTRITION INFORMATION AND WAIVER OF CLAIMS ARISING FROM RECEIPT OF FITNESS AND NUTRITION INFORMATION
IN CONSIDERATION OF the risk of injury that exists while participating in Nutrition and Fitness Services (hereinafter the "ACTIVITY" or “ACTIVTIES”); and the fitness, exercise and nutrition information provided by Fitness/Nutrition Coach and Weight loss Specialist, Stacey Timbo (hereinafter “COACH”) and/or MOVE-MENT heirs, executors, administrators, assigns, agents or personal representatives (hereinafter “Move-ment”), is designed for and solely intended to be suggestions which YOU (the Participant/Client) may voluntarily implement, follow, or incorporate into YOUR lifestyle and diet and which YOU consent to. Use of any fitness and nutrition information provided is completely voluntary and YOU are solely responsible for YOUR voluntary choice to implement the fitness and dietary suggestions. It is the sole responsibility of YOU to provide complete and accurate information. Any misinformation or omitted information provided by YOU may affect any fitness and/or nutritional assessment or advice provided by the COACH. Any misrepresented information is solely YOUR responsibility and Stacey Timbo/COACH and Move-ment will not be liable for any harm that may result from YOUR participation in the ACTIVITY OR ACTIVITIES.
IN CONSIDERATION OF my desire to participate in said ACTIVITY or ACTIVTIES and being given the right to participate in same; COACH provides fitness and nutrition consulting and recommendations only and is not licensed to diagnose a medical condition or illness. YOU must consult a physician for any medical advice and should consult a physician before participating in any of the ACTIVITY or ACTIVTIES.
I HEREBY, for myself, my heirs, executors, administrators, assigns, agents, or personal representatives (hereinafter collectively, "Releasor," "I" or "me", which terms shall also include Releasor's parents or guardian if Releasor is under 18 years of age), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and hereby WAIVE and RELEASE any and all rights, claims or causes of action of any kind arising out of my participation in the ACTIVITY or ACTIVTIES; and
I HEREBY RELEASE and FOREVER DISCHARGE COACH and/or MOVE-MENT, located at 311 Woods Dr, Plymouth Meeting, Pennsylvania 19462, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns (collectively "Releasees"), from any physical or psychological injury or harm that I may suffer as a direct result of my participation in the aforementioned ACTIVITY or ACTIVTIES.
I FURTHER AGREE to indemnify, defend and hold harmless the Releasees against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs.
I FURTHER ACKNOWLEDGE that Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Releasees. In the event that I should require medical care or treatment, I authorize COACH and/or Move-ment to provide all emergency medical care deemed necessary, including but not limited to, first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of any such treatment. I am aware and understand that I should carry my own health insurance.
I FURTHER ACKNOWLEDGE that the Activity/Activities may involve a test of a person's physical and mental limits and may carry with it the potential for death, serious injury, and property loss. I agree not to participate in the Activity/Activities unless I am medically able and properly trained, and I agree to abide by the decision of the Move-ment official or agent, regarding my approval to participate in the Activity.
I have volunteered to participate in the ACTIVITY or ACTIVTIES provided by COACH and/or Move-ment and under the direction of COACH, which will include, but may not be limited to nutritional planning and fitness programs as described herein. In consideration of COACH and/or MOVE-MENT’s agreement to assist me, I do here and forever RELEASE AND DISCHARGE and hereby hold harmless Move-ment, Stacey Timbo (COACH) and her respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in any ACTIVITY or ACTIVTIES entirely at my own risk which may include, but not limited to: physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and death. I understand that these injuries or outcomes may arise from my own or other’s negligence, conditions related to travel to and from the activity, or from conditions at the activity location(s). Nonetheless, I assume all related risks, both known and unknown to me, of my participation in this activity.
To the extent that statute or case law does not prohibit releases for ordinary negligence, this release is also for such negligence on the part of COACH and/or Move-ment, its agents, and employees.
I agree that this WAIVER AND RELEASE shall be governed for all purposes by Pennsylvania law, without regard to any conflict of law principles. This WAIVER AND RELEASE supersedes any and all previous oral or written promises or other agreements.
In the event that any damage to equipment or facilities occurs as a result of my or my family's or my agent's willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any such actions of neglect or recklessness.
THIS WAIVER AND RELEASE OF LIABILITY SHALL REMAIN IN EFFECT FOR THE DURATION OF MY PARTICIPATION IN THE ACTIVITY, DURING THIS INITIAL AND ALL SUBSEQUENT EVENTS OF PARTICIPATION.
THIS WAIVER AND RELEASE was entered into at arm's-length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both Participant, _________________________ and COACH/MOVE-MENT agree that this WAIVER AND RELEASE is clear and unambiguous as to its terms, and that no other evidence shall be used or admitted to alter or explain the terms of this WAIVER AND RELEASE, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into.
In the event that any provision contained within this WAIVER AND RELEASE of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this WAIVER AND RELEASE shall remain in full force and effect. If a court should find that any provision of this WAIVER AND RELEASE to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.
I, THE UNDERSIGNED PARTICIPANT, AFFIRM THAT I AM OF THE AGE OF 18 YEARS OR OLDER, AND THAT I AM FREELY SIGNING THIS AGREEMENT. I CERTIFY THAT I HAVE READ THIS AGREEMENT, THAT I FULLY UNDERSTAND ITS CONTENT AND THAT THIS RELEASE CANNOT BE MODIFIED ORALLY. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND THAT I AM SIGNING IT OF MY OWN FREE WILL.
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