Accident Waiver and Release of Liability Form

I HEREBY ASSUME ALL OF THE RISKS OF EXERCISING OR WORKOUTS IN ANY FORM AT THE CORE, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities 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, that there are no health-related reasons or problems which preclude me from participation in any activity at The CORE. I also certify that I HAVE NOT been advised by a qualified medical professional NOT to participate in such activities.

I acknowledge that activity and exercise may involve a test of a person’s physical and mental limits and carries with it the potential for death, serious injury, and property loss.

I acknowledge that any injuries sustained in voluntary participation in exercising, workouts or other activities at The CORE by employees of Labette and its subsidiaries are not covered by Workers Compensation.

I hereby consent to medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during activity or exercise.

(A) I WAIVE, RELEASE, AND DISCHARGE Labette and its subsidiaries or employees 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 Labette Health and its subsidiaries or employees 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.

This accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extend permissible under applicable law.

I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND IT’S CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT, AND I SIGN IT OF MY OWN FREE WILL.

The undersigned parent or guardian does hereby represent that he/she is, in fact, acting in such capacity, has consented to his/her child or ward’s participation, and has agreed individually and on behalf of the child or ward, to the terms of the Waiver and Release of Liability set forth above in paragraphs (A) and (B).