Registration

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATION IN Fitness Training with Move The Rock Fitness, L.L.C, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the person being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I certify that I am physically fit, have sufficiently prepared or trained in the activity or event, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems that prelude my participation in this activity or event. I acknowledge that this Accident Waiver and Release of Liability Form will be used by the program holder, sponsors, and all other organizers of the activity or event in which I may participate, and that it will govern my actions and responsibilities at said activity or event. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A)I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this event. (B)I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity or event, whether caused by the negligence of release or otherwise. I acknowledge the existence of risks in connection with my participation in the training program. My participation in the activities is purely voluntary and I hereby elect to participate with full knowledge of the risks of injury and/or illness that may result from such participation. I accept full responsibility for any injuries, illness or damage to property that I may sustain or cause in the course of participating in the program. More specifically, I acknowledge and accept the following risks: 1) Possible accidents, injuries, medical disorders, pain and suffering, lost income and medical expenses resulting from participation in the program. 2) Possible injuries and medical disorders arising out of the program may include, but are not limited to, cardiac and pulmonary distress (including heart failure), stroke, exhaustion, sprains, broken bones, torn muscles and ligaments, cuts, scrapes, bruises, dislocations, concussions, nerve damage, eye injury, tendonitis, and brain or spinal cord injuries, which may result in temporary or permanent paralysis, loss of bodily functions, disability, or even death. 3) The risks listed herein may be caused by my own actions or inactions, the actions or inactions of others participating in the program, or the conditions under which the program take place or are conducted. Some activities are performed individually, while other activities may involve other participants. I acknowledge the existence of certain rules and procedures concerning my participation in the program and I agree to abide by those rules and procedures. I understand that failure to abide by the instructions, rules, or policies/procedures may cause me to be prohibited from the program. I have read and understand this Agreement. I am aware of the level of exertion required to participate in the program and acknowledge that I have the requisite skills and fitness level to participate without causing harm to myself or to others. I have verified with my physician or other medical professional that I have no past or current physical or psychological conditions that might affect my ability to participate in the program. I authorize Move The Rock Fitness, L.L.C Trainers to obtain or provide emergency hospitalization, surgical or other medical treatment for me and acknowledge that I will be financially responsible for any injury, damage or cost which might arise out of or be incurred in connection with such emergency medical treatment. I understand that the laws of the state of Wisconsin govern this Assumption of Risk and Personal Responsibility User Agreement. I agree that if any portion of this Agreement is held to be invalid, the balance shall continue in full force and effect. My decision to sign this Agreement is purely voluntary. I hereby release and discharge Move The Rock Fitness, L.L.C and all contracted personal trainers from any claims, suits, liability, demands, losses, or damages on my account caused or alleged to be caused in whole or party by: (a) defective or dangerous equipment, facilities, or premises; or (b)misuse of the equipment, premises or facilities, including that caused by a failure to warn or supervise. I further agree that if I or anyone on my behalf makes a claim or files suit against Move the Rock Fitness, L.L.C., I will indemnify, save and hold Move The Rock Fitness, L.L.C., from any and all litigation expenses, attorney’s fees, loss, liability, damages, or costs that are incurred as the result of such claim or suit. This Assumption of Risk and Personal Responsibility User Agreement shall remain in full force and effect throughout the duration of the undersigned’s membership in the program. I hereby acknowledge that: 1) I have read, understand and accept the terms and conditions stated in this Assumption of Risk and Personal Responsibility User Agreement (including such parts as may subject me to personal financial responsibility), 2) I am and will be legally responsible for the obligations and acts of whose names are set forth, and 3) I agree, for myself to be bound by all the terms and conditions set forth herein. I further acknowledge that this Agreement shall be effective and binding upon my heirs, my assigns, personal representatives, estate and myself.