THIS RELEASE AND WAIVER OF LIABILITY AGREEMENT (the “Agreement”) is made and entered into as of the date set forth below, by and between Physiovation, LLC (“Physiovation” or the “Provider”) and the undersigned parent(s) or legal guardian(s) (collectively referred to as “Parent/Guardian”) on behalf of the minor child identified below (“Minor”).
WHEREAS, the Provider provides personal training, physical therapy, and/or class and individual workout programs and strength training (collectively referred to as “Activities” or singularly as an “Activity”); and
WHEREAS, the Parent/Guardian desires that the Minor receive the Activities from the Provider; and
WHEREAS, the Parent/Guardian acknowledges and understands that there are certain risks inherent in the Activities and that results cannot be guaranteed.
NOW, THEREFORE, in consideration of the Provider providing the Activities to the Minor, and other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:
1. CONSENT TO TREATMENT
Parent/Guardian hereby consents to the Provider providing the Activities to and/or facilitating the activities for the Minor. Parent/Guardian acknowledges that they have been informed of the recommended scope of the Activities and that they understand the nature, risks, and benefits of the Activities. Parent/Guardian further acknowledges that they have had the opportunity to ask questions regarding the Activities and that all questions have been answered to their satisfaction.
2. ASSUMPTION OF RISK
Parent/Guardian, on behalf of themselves and the Minor, acknowledges and understands that participation in the Activities involves inherent risks, including but not limited to:
1. Physical discomfort, pain, injury, worsening of existing conditions, or in rare circumstances, death;
2. Failure to achieve desired results or improvement in the Minor's condition;
3. Adverse physical and psychological reactions to treatment modalities, exercises, or equipment;
4. Accidents or injuries that may occur on the Provider's premises; and
5. Other risks associated with physical therapy, strength training, and/or exercise.
Parent/Guardian, on behalf of themselves and the Minor, hereby expressly and voluntarily assumes all such risks, both known and unknown, associated with the Minor's participation in the Activities, even if arising from the negligence of the Provider or any of its employees, agents, or representatives.
3. RELEASE FROM LIABILITY
Parent/Guardian, on behalf of themselves and the Minor, hereby releases, waives, discharges, and covenants not to sue the Provider, its owners, directors, officers, employees, agents, representatives, volunteers, successors, and assigns (collectively, the “Released Parties”) from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, now known or hereafter known, that may be sustained by the Minor, the Parent/Guardian, or any property belonging to Parent/Guardian or the Minor, whether caused by the negligence of the Released Parties or otherwise, while the Minor is participating in the Activities, is on the Provider's premises, or as a result of the Minor’s participation in the Activities or entering the Provider’s premises.
4. COVENANT NOT TO SUE
Parent/Guardian, on behalf of themselves and the Minor, agrees not to institute any suit or action at law or otherwise against the Released Parties, nor to initiate or assist in the prosecution of any claim for damages or cause of action which the Minor, Parent/Guardian, or the Minor's heirs, executors, administrators, or assigns may have by reason of injury to the Minor's person or property or the Minor's death, arising from or in any way related to the Activities provided by the Provider, whether caused by the negligence of the Released Parties or otherwise.
5. INDEMNIFICATION
Parent/Guardian hereby agrees to defend, indemnify, and hold harmless the Released Parties from and against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including attorneys’ fees, fees, the costs of enforcing any right to indemnification under this Release, and the cost of pursuing any insurance providers, incurred by/awarded against the Provider or any other Releasees, rising out of or resulting from any claim of a third party related to the Minor’s participation in the Activities and/or the Minor’s entering of the Provider’s Premises, including any claim related to the negligence of the Minor, the Parent/Guardian, or the ordinary negligence of the Provider.
6. MEDICAL TREATMENT RELEASE
In the event of an injury or medical emergency involving the Minor during the Activities, Parent/Guardian hereby authorizes the Provider to:
1. Administer first aid and other emergency medical treatment to the Minor;
2. Contact emergency medical services (EMS) or other medical professionals;
3. Arrange for the transportation of the Minor to a hospital or other medical facility; and
4. Consent to emergency medical treatment for the Minor if Parent/Guardian cannot be reached.
Parent/Guardian agrees to assume all financial responsibility for any costs associated with such emergency medical treatment and releases the Released Parties from any liability for actions taken in good faith to provide or obtain emergency medical treatment for the Minor.
7. HEALTH INFORMATION AND MEDICAL HISTORY
Parent/Guardian represents and warrants that they have provided the Provider with a complete and accurate medical history for the Minor, including all known allergies, medications, medical conditions, previous injuries, surgeries, and other health information that may be relevant to the Activities. Parent/Guardian agrees to promptly update the Provider regarding any changes to the Minor's health status or medical history. Moreover, Parent/Guardian confirms that the Minor is in good health and proper physical condition and does not have any medical or other conditions that would impair their ability to participate in the Activities. Parent/Guardian acknowledges that the Provider is relying on these statements to allow me to participate in the Activity.
8. RESPONSIBILITY FOR PERSONAL PROPERTY
Parent/Guardian acknowledges and agrees that the Provider is not responsible for any personal property brought to the Provider's premises by the Minor or Parent/Guardian, including but not limited to clothing, jewelry, electronic devices, or other valuables. Parent/Guardian assumes all risk of loss, damage, or theft of such personal property.
9. NO REPRESENTATIONS BY PRACTICE
Parent/Guardian acknowledges that no representations, statements, or inducements, oral or written, apart from the foregoing written statement, have been made to Parent/Guardian regarding the Activities or this Agreement. Parent/Guardian is not relying on any statements or representations not set forth in this Agreement in deciding to allow the Minor to participate in the Activities.
10. COMPLIANCE WITH RULES AND INSTRUCTIONS
Parent/Guardian agrees that the Minor will comply with all rules, regulations, and instructions of the Provider while participating in the Activities or while on the Provider's premises. Parent/Guardian acknowledges that failure to comply with such rules, regulations, or instructions may result in the termination of Activities.
11. PARENT/GUARDIAN RESPONSIBLE FOR PAYMENT
Parent/Guardian understands and agrees that they are solely responsible for all costs related to the Activities within thirty (30) days of service. Any past due amount may be subject to a monthly 10% late fee.
12. GOVERNING LAW AND VENUE
This Agreement has been negotiated, drafted and executed within the State of Georgia and shall be construed according to the laws of the State of Georgia, without giving effect to the conflict of laws provisions thereof. The parties agree that any dispute under or arising out of this Agreement shall be litigated solely and exclusively within either (a) the federal courts with appropriate jurisdiction within the State of Georgia, or (b) the state court with appropriate jurisdiction located in Fulton County, Georgia. The parties hereby waive any objection to venue, forum, or jurisdiction in such courts and consent to personal jurisdiction in such courts, even if the parties are not resident in Georgia at the time any dispute arises out of or involves this Agreement.
13. WAIVER
No waiver of any term or right in this Agreement shall be effective unless in writing and signed by an authorized representative of the waiving party. The failure of either party to enforce any provision of this Agreement shall not be construed as a waiver or modification of such provision, or impairment of its right to enforce such provision thereafter.
14. SURVIVAL
Any provision of this Agreement providing for performance by either party after termination of this Agreement shall survive such termination and shall continue to be effective and enforceable.
15. SEVERABILITY
If any provision or portion of this Agreement shall be held by a court of competent jurisdiction to be invalid, void, or unenforceable, the remaining provisions shall remain in full force and effect and shall in no way be affected, impaired, or invalidated.
16. ENTIRE AGREEMENT; MODIFICATION; BINDING EFFECT
This Agreement contains the entire agreement between the parties concerning the subject matter hereof and supersedes all prior agreements, understandings, discussions, negotiations, and undertakings, whether written or oral, between the parties with respect thereto. This Agreement may only be modified by a written document executed by both parties. This Agreement shall be binding upon and inure to the benefit of the parties hereto and their respective heirs, executors, administrators, legal representatives, successors, and permitted assigns.
17. ACKNOWLEDGMENT OF UNDERSTANDING
I, THE UNDERSIGNED PARENT/GUARDIAN, HEREBY ACKNOWLEDGE THAT I HAVE READ THIS ENTIRE AGREEMENT, THAT I FULLY UNDERSTAND ITS TERMS, THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND THAT I AM SIGNING IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. I UNDERSTAND THAT MY SIGNATURE BELOW EXPRESSLY RELEASES THE RELEASED PARTIES FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE, OR WRONGFUL DEATH CAUSED BY THE NEGLIGENCE OF THE RELEASED PARTIES, EXCEPT AS OTHERWISE PROHIBITED BY LAW.