Waiver and Release
In consideration of being permitted by BARRE TEND, LLC, a New York limited liability company (“BARRE TEND”) to participate in barre, yoga, and any and all other fitness classes, exercises, and workshops offered by BARRE TEND (hereinafter rereferred to as the “Fitness Classes”), I hereby understand, acknowledge, and agree that:
1. It is understood that this WAIVER AND RELEASE is being given in advance of any participation in Fitness Classes and is being given by me voluntarily to participate in the Fitness Classes. I fully understand the Fitness Classes and other services offered by BARRE TEND and that they have been satisfactorily explained to me and I have all of the information I desire.
2. In consideration for participating in the Fitness Classes located at 503 delaware ave., buffalo, ny 14202 (the “Location”), I, my heirs, successors, assigns, and on and behalf of my children to which I am a parent or guardian to, hereby RELEASE, WAIVE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY, DEFEND AND HOLD HARMLESS BARRE TEND and any of its members, officers, managers, employees, agents, representatives, affiliates, successors and assigns (hereinafter referred to as RELEASEE) from any and all liability, claims, demands, losses, costs and expenses, including without limitation, court costs and attorneys’ fees, actions and causes of action whatsoever arising out of, related to, or in connection with any damage or injury that may be sustained by me or my infant or child, whether known, unknown, anticipated or unanticipated, directly or indirectly arising out of, in relation to, or resulting in whole or in part from my and/or my infant’s or child’s participation in Fitness Classes, exercise classes, workshops, use of equipment, or being present at the Location in any way and for any reason, including, but not limited to, any claims of physical or psychological illness or injury, bodily harm, medical expenses, costs of medical emergency care and/or transport, death, damage to real or personal property, and loss or theft of personal property, regardless of whether such claims arise in whole or in part from the acts, omissions or negligence of the RELEASEE and forever release and discharge RELEASEE from liability for any such claims. Further, I agree to assume full responsibility for any risks, injuries or damages, known and unknown, which my child or infant might incur as a result of participating in the Fitness Classes. In further consideration of being permitted to participate in the Fitness Classes, I, for myself, my heirs, successors, assigns, and on and behalf of my children or infant children, knowingly, voluntarily, and expressly waive and release any claim I or my child or infant may have against RELEASEE, for injuries, death or damages that my child or infant may sustain as a result of participating in Fitness Classes and other activities offered by BARRE TEND.
3. I am fully aware of the risks connected with participating in Fitness Classes, and I am voluntarily participating in said Fitness Classes, and participant in Fitness Classes at the Location. . I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS that may be engaged in such an activity, including the risks associated with any physical activity during pregnancy or with my child or infant who participates in the Fitness Classes. I acknowledge that participation in Fitness Classes involves risk of bodily injury, illness, disability or death, which may be compounded by negligent emergency response of RELEASEE. I acknowledge that I am voluntarily, or if a parent or guardian for a minor child, allowing my child, to participate in Fitness Classes and/or other physical activity related to Fitness Classes at the Location with knowledge of the dangers involved and accept and assume all risks and injury, illness, disability or death, whether caused by the condition of the Location or equipment used in furtherance of the Fitness Classes, or the negligence of RELEASEE or otherwise.
4. From time to time BARRE TEND instructors may physically adjust participants’ form and posture. If at any time I do not want such physical adjustments, or if a particular adjustment is causing pain or other discomfort, it is my sole responsibility to inform the instructors to refrain from or cease physical contact.
5. BARRE TEND is open to the general public, Fitness Classes are provided for everyone’s benefit and enjoyment, and any disruptions could impede other class members’ participation and safety. At the sole discretion and request of BARRE TEND staff or the property owners, I will leave the Location immediately and peacefully. Further, BARRE TEND staff may terminate my participation in Fitness Classes at any time and for any reason in their sole discretion. I agree that I will comply with all instructions on the participation of Fitness Classes at the Location. I agree to use all Fitness Classes and sessions within the terms of the contract dates and understand that refunds are not given on unused portions of purchased packages.
6. I understand that participation in the Fitness Classes are designed only by persons in good general physical health. I have been advised that if I suffer from any medical condition or illness whatsoever, I am NOT TO participate in the Fitness Classes without my doctor’s written permission, which permission shall be received by BARRE TEND prior to participation. It is my sole responsibility to participate in exercises that are appropriate for the current status of my health. I represent and warrant that I am in good physical condition and do not suffer from any impairment, disability, disease, or other physiological or psychological medical condition that could prevent or limit my participation in the Fitness Classes. I understand that a physician’s examination and approval should be obtained by anyone prior to commencing a fitness and/or exercise program, or otherwise initiating a substantial change in the amount of regular physical activity performed, and if I have chosen not to obtain a physician’s consent prior to participating in Fitness Classes, I am doing so solely at my own risk. I am fully aware that even with a physician’s examination and approval, any physical activity should be done in moderation and never should be performed to the point of fatigue or pain. I am solely and fully responsible for monitoring my own condition throughout my participation in Fitness Classes; if I begin to experience fatigue and/or pain, I immediately will cease all physical activity and seek proper medical attention, or, at my sole discretion and risk, I will reduce and/or adjust my level of activity during the applicable Fitness Class. If my child or infant, to which I am a parent or guardian, is participating in Fitness Classes or services offered by BARRE TEND, I recognize and agree that Fitness Classes require physical exertion, which may be strenuous and may cause physical injury to my child or infant, and I am fully aware of the risks and hazards involved. I understand that it is my responsibility to consult with a physician prior to and regarding my child’s participation in any physical fitness program, including those offered by BARRE TEND. I represent and warrant that my child has no medical condition that would prevent her/his participation in physical fitness activities at BARRE TEND.
7. PREGNANT PARTICIPANTS. If I am pregnant, and prior to signing this WAIVER AND RELEASE, I hereby agree to provide BARRE TEND with written permission of my treating physician to participate in Fitness Classes. To my knowledge, I do not have any limiting physical conditions, which would prevent me from participating in Fitness Classes at BARRE TEND. I understand and agree that I will not be able to enroll or to continue in Fitness Classes during the term of my pregnancy without the prior written permission of my treating physician. I agree to keep my physician informed of the effects of the Fitness Classes on my body and to consult him/her whenever necessary. I further understand that there is no requirement to perform all the class exercises and that I can withdraw at any time. During Fitness Classes, I agree to limit my activity to that which is comfortable for me and to stop all activity immediately if I feel uncomfortable. Upon experiencing any discomfort at any time either during or after Fitness Classes, I will immediately contact my treating physician to inform him/her and seek medical advice.
8. PHOTO RELEASE. I hereby grant the BARRE TEND permission to use my and/or my child’s likeness in a photograph, video, or other digital media (“Photos”) in any and all of its publications, including, but not limited to, web-based publications, social media, advertising and similar purposes that nor or in the future are prepared and/or used by BARRE TEND in all present and future forms of media without payment or other consideration. I understand and agree that all Photos will become the exclusive property of BARRE TEND. I hereby irrevocably authorize BARRE TEND to edit, alter, copy, exhibit, publish, or distribute these Photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the Photos. I hereby hold harmless, release, and forever discharge BARRE TEND from all claims, demands, and causes of action which I, my heirs, representatives, successors, assigns, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. I hereby knowingly and voluntarily agree and represent that I am authorized to agree on behalf of any minor child as his or her other parent(s) or guardian(s) – to expressly, fully and forever waive, release, discharge, covenant not to sue, and agree to indemnify, defend, and hold harmless BARRE TEND from and against any and all claims directly or indirectly arising out of, relating to or resulting in whole or in part from BARRE TEND’S capture and use of the Photos.
9. It is my express intent that this WAIVER AND RELEASE shall bind my spouse, dependents, heirs, successors and assigns and shall be deemed as a RELEASE, WAIVER, AND DISCHARGE of the above named RELEASEE. I hereby further agree that this WAIVER AND RELEASE shall be construed in accordance with the laws of the State of New York.
10. I agree and understand that this WAIVER AND RELEASE is intended to be as broad and inclusive as permitted under law. I specifically acknowledge and agree that this WAIVER AND RELEASE is intended to be a general release subject to limitations and conditions that would otherwise apply under applicable state law and additionally I agree to waive all general release limitations provided by applicable law.
11. If any portion of WAIVER AND RELEASE is held invalid, the remainder shall not be affected and shall continue in full legal force and effect.
12. The terms of this WAIVER AND RELEASE shall continue from this date forever and shall apply to each and every time I participate in Fitness Classes at the Location without the need for me to resign this WAIVER AND RELEASE.
13. This document, including any exhibits or attachments hereto, constitutes the entire agreement regarding participation in the Fitness Classes at the Location and supersedes all prior discussions and representations about the use, benefits or risks of Fitness Classes and/or other services at the Location.
I HAVE CAREFULLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A POTENTIAL CONFLICT BETWEEN MYSELF, AND MY HEIRS, SUCCESSORS, ASSIGNS AND BARRE TEND. I VOLUNTARILY AGREE TO EACH OF THE TERMS AND PROVISIONS HEREIN AND SIGN THIS OF MY OWN FREE WILL. IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I AM AT LEAST EIGHTEEN (18) YEARS OF AGE AND FULLY COMPETENT; AND I EXECUTE THIS WAIVER AND RELEASE FOR FULL, ADEQUATE, AND COMPLETE CONSIDERATION FULLY INTENDING TO BE BOUND BY THE SAME.
Participant’s Printed Name: ____________________________
PARENTAL CONSENT FORM FOR MINORS UNDER THE AGE OF 18
If under 18 years of age, parental consent is required. Please complete below for consent of a minor.
I, (Print name: Parent or Legal Guardian) ________________________________________ acknowledge that I have read and understand the WAIVER AND RELEASE on behalf of my minor child ____________________. I further agree and consent that my minor child ___________________________, may voluntarily participate in Fitness Classes and other services offered at the Location and shall be bound by the terms and conditions set forth in the WAIVER AND RELEASE.
Parent/Guardian Printed Name ___________________________________________
THE WAIVER AND RELEASE IS DEEMED TO HAVE BEEN READ, UNDERSTOOD, AND SIGNED BY EVERY PARENT OR GUARDIAN WHO INDICATES HIS OR HER CONSENT HERETO.