Charged Up Hikers Participation Form

Name*

First NameLast Name

E-mail*

Phone Number*

Area CodePhone Number

What is your hiking experience:*

BeginnerIntermediateAdvanced

Emergency Contact: *

First NameLast Name

What do you enjoy most about hiking? *

Emergency Contact Phone Number

Area CodePhone Number

If you have any children, are they attending with you?

YesNoNot Applicable

If "YES" please write each person's first and last name here:

How did you hear about the event?*

Name of media source, platform or person

Have you tried Herbalife products before?*

YesNo

Are you interested in learning more about Herbalife and how it can help your wellness journey?*

YesNo

MULTIMEDIA NOTICE

Periodically photos or videos may be taken for educational or marketing purposes. By signing this form you are consenting to having the participant/spouse/children in print and digital media for Charged Up Nutrition Bar. Additionally, you waive any and all present or future compensation rights to the use of the media stated above.

WAIVER AND RELEASE OF LIABILITY

In consideration of Charged Up Nutrition Bar, the Coaches/Trainers, and/or equipment to enable me to participate in the community workout, I agree as follows:

I fully understand and acknowledge that:

Risks and dangers exist in my use of Charged Up Nutrition Bar equipment and my participation in Charged Up Nutrition Bar activities.
My participation in such activities and/or use of such equipment may result in my injury or illness, including, but not limited to bodily injury, fractures, partial and/or total paralysis, eye injury, heat stroke, heart attack, death, or other ailments that could cause severe disability.
These risks and dangers may be caused by the negligence of the coaches, the negligence of the participants, the negligence of others, the forces of nature or other causes.
By my participation in these activities and/or use of equipment, I hereby assume all risks and dangers and all responsibility for any losses and/or damages, whether caused in whole or in part by the negligence or other conduct of the coaches, or other employees of "Charged Up Nutrition Bar", or by any other person.

I, on behalf of myself, my personal representatives, and my heirs, hereby voluntarily agree to release, waive, discharge, hold harmless, defend, and indemnify Charged Up Nutrition Bar, its owners, coaches/ trainers from any and all claims, actions, or losses for bodily injury, property damage, property lost and/or stolen wrongful deaths, loss of services or otherwise which may arise out of the use of Charged Up Nutrition Bar equipment, or my participation in Charged Up Nutrition Bar activities. I expressly understand that I am releasing, discharging, and waiving any claims or actions that I may have present or in the future for the negligent acts or other conduct by the owners, coaches/ trainers.

I HAVE READ THE ABOVE WAIVER AND RELEASE OF LIABILITY BY SIGNING IT. I AGREE THAT IT IS MY INTENTION TO EXEMPT AND RELEASE CHARGED UP NUTRITION BAR OF ALL THE ABOVE MENTIONED IN THIS FORM. REMEMBER YOU ARE DOING THIS AT YOUR OWN RISK.

By signing below, I acknowledge and accept all the terms outlined in the above multimedia notice, waiver and release of liability.

Signature*