IAKWA'SHATSTE RELEASE OF LIABILITY AGREEMENT

By signing this document, you will waive certain legal rights, including the right to sue.

AWARENESS AND ASSUMPTION OF RISK

I am aware that Iakwa'shatste Youth Fitness Programming involves risks including risk of personal injury, death, property damage, expense and related loss. Included in these risks are negligence on the part of Iakwa'shatste Youth Fitness, its directors, officers, officials and volunteers, other participants and owners of the facilities where the activities occur. I freely accept and fully assume all such risks and the possibility of personal injury, death, property damage, expense and related loss, including loss of income.

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT

In consideration of Iakwa'shatste Youth Fitness accepting my application to participate in this activity, I

1. To waive any and all claims that I may have in future against Iakwa'shatste Youth Fitness AND 2.To release Iakwa'shatste AND OTHERS from any and all liability for any personal injury, death, property damage, expense and related loss, including loss of income that I or my next of kin may suffer as a result of my participation in this activity, due to any cause whatsoever, including negligence, breach of contract or breach of any statutory duty of care. 3. To hold harmless and indemnify Iakwa'shatste Youth Fitness AND OTHERS from any and all liability for any damage to property of, or personal injury to, any third party, resulting from my participation in this activity. 4. That this agreement is binding on not only myself but my next of kin, heirs, executors, administrators and assigns.

I HAVE READ THIS AGREEMENT AND UNDERSTAND IT. I AM AWARE THAT BY SIGNING THIS DOCUMENT I AM WAIVING CERTAIN RIGHTS WHICH I OR MY NEXT

OF KIN, HEIRS, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY HAVE AGAINST IAKWA'SHATSTE YOUTH FITNESS AND OTHERS.

What program are you participating in?*

Name of the Program your participating in ( dryland training, kayaking, dance)

Participants Name*

Your Name or child's Name

Participants DOB*

Your DOB or child's DOB

Medical Conditions or allergies*

Participants Medical conditions or allergies

Parent Guardian Name (if under 16)*

For participants under 16

Phone Number*

Format: (000) 000-0000.

Emergency contact Name*

Emergency contact number*

Please enter a valid phone number.Format: (000) 000-0000.

Release of Liability and Assumption of Risk Agreement.

Signature*

Date*

Date

PHOTO RELEASE

I hereby authorize lakwa'shatste Youth Fitness to publish photographs/video taken of myself or child/children at the above-named activity/event. I further acknowledge that my participation is voluntary and that I will not receive financial compensation of any type associated with taking or publication of these photographs/video. I release lakwa'shatste Youth Fitness, its employees and any third party involved in the creation or publication of photographs/video from above activity/event by myself or a third party in connection with our participation.

Signature*

Date*

Date

RELEASE OF LIABILITY, WAIVER OF CLAIMS ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT