Informed Consent and Waiver & Release of Lability
I have elected to participate in a program of progressive physical exercise and to retain the services of Hallee Altman, LLC to receive physical training. I hereby assume all risk of injury from my participation. To that end, I acknowledge and agree to all of the following:
1. The exercise program utilizes a technique of muscle conditioning, strengthening and stretching. The possible benefits of this program include improved muscle strength, endurance, flexibility, improved body posture and alignment. During exercise, there exists a potential for muscle tears, soreness or stiffness, sprains, strains and breaks, abnormal blood pressure, fainting, feelings of tiredness, lightheadedness, mood changes, heart beat disorders and instances of heart attack, paralysis, and other severe injuries up to and including death. I assume all of the foregoing risks, and accept personal responsibility for any and all other damages or other injury I might suffer.
2. I know I have the express right to decline any exercise at any time. In addition, I may withdraw from any exercise at any time.
3. I understand that an examination and approval by a physician should be obtained prior to participation in any exercise program. I further understand that I should continue to keep my instructor at Hallee Altman, LLC fully informed of any physical condition or disability which could prevent or limit my participation in an exercise or physical conditioning program.
4. I hereby fully and forever release, discharge and hold harmless Hallee Altman, LLC, its employees, officers, directors, agents and independent contractor instructors, from any and all liability to me, my heirs and next of kin, for any and all claims, demands, rights of action, causes of action, losses or damages on account of injury including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of Hallee Altman, LLC, its employees, officers, directors, agents or independent contractor instructors, and I hereby waive any right to sue any of the foregoing for any injuries I may sustain or losses I may incur whether known or unknown directly or indirectly resulting from any of the activities described above.
5. I recognize that my participation in the activities covered hereby is expressly conditioned upon my agreement to each and every term herein and my signing and returning this waiver and release form. I understand that I may show this informed consent and waiver & release of liability to my own independent legal counsel before signing.
6. I have read and understood this informed consent and waiver & release of liability and it accurately sets forth my intentions and I agree to be bound by its provisions.