THE FOLLOWING IS A WAIVER. READ IT BEFORE SIGNING
BY AFFIXING MY SIGNATURE TO THIS DOCUMENT, I ATTEST, CONTRACT, UNDERSTAND AND AGREE THAT I AM TO BE LEGALLY BOUND BY ITS CONTENTS. I hereby stipulate and agree:
That I realize there are risks to cardiovascular exercise, weight training, yoga, and any other physical activity, and I am fully aware of the possibility of mechanical and/or other malfunctions of cardiovascular equipment, weight machines, and/or weight machines and apparatus, [“equipment”] due to the negligence of Kevin Perrone or any instructor associated with Kinetic Potential, as well as the possibility of injury to my person as a, result of the use of such cardiovascular equipment, weights, and/or weight machines and apparatus. I, therefore fully understand and I am mindful of the serious consequences which might result due to my involvement in cardiovascular exercise, weight lifting, weight training, and bodywork, while at any location while engaged in a session with Kevin Perrone or any one associated with activities at Kinetic Potential, and based on that understanding, as set forth in this paragraph, I voluntarily assume any and all risk of loss, damage or injury of any kind what so ever from my use of any and all of the equipment and facilities, and further and with full knowledge of the consequences (i.e. that I am waiving my right to sue) expressly waive any and all liability on the part of Kevin Perrone, and his respective trustees, beneficiaries, staff, and officers from my use of any location while engaged directly or indirectly in a session with Kevin Perrone.
That I am physically sound and have medical approval to proceed with a normal routine of exercise. That all exercises shall be undertaken by me at my sole risk. That I am in good health and have no physical conditions that would be aggravated by my involvement in cardiovascular exercise, weight lifting, bodywork, and/or weight training, nor do I have any physical limitations that would preclude said involvement. I also release Kevin Perrone and any instructor associated with Kinetic Potential from liability for negligence, defective equipment, injuries from dangerous conditions of property, etc.
That I am forewarned that Kevin Perrone or instructors from Kinetic Potential will not in any event provide medical and/or hospitalization insurance for my benefit, and in the event of an injury to my person occurring either as a result of my being on any portion of the location in which a session is being conducted. I will save harmless and keep indemnified Kevin Perrone and his respective trustees, beneficiaries, staff, and officers from and against any and all action claims, costs, expenses or demands, in respect of such injury or injuries, including death, howsoever caused, arising out of or in connection with my use of any facilities or my being on any portion of said premises and notwithstanding that the same may have been contributed to or occasioned by the negligence of Kevin Perrone and his representatives, officers, directors, trustees and or beneficiaries.
I understand that Kevin Perrone is a Licensed Massage and Bodywork Therapist and that any bodywork performed on the myself is totally voluntary and may be refused and anytime even if the session has already begun. I understand it is my responsibility to relate any pain or discomfort experienced and that Kevin Perrone intends to work within individual client tolerance. I understand that anything is possible during and following a bodywork session including but not limited to: bruising, pain, swelling, discomfort, emotional or psychological changes, dizziness, and nausea. I understand that all bodywork or massage work is meant to be therapeutic in nature only.
Because physical exercise can be strenuous and subject to risk of serious injury, I urge you to obtain a physical examination from a doctor before using any exercise equipment or participating in any exercise activity. You agree that by participating in physical exercise or training activities, whether or not they are directly supervised, you do so entirely at your own risk. Any recommendation for changes in diet including the use of food supplements, weight reduction and/or body building enhancement products are entirely your responsibility and you should consult a physician prior to undergoing any dietary or food supplement changes. You agree that you are voluntarily participating in these activities and use of these facilities and premises and assume all risks of injury, illness, or death. I am also not responsible for any loss of your personal property.
I understand that it is my responsibility to inform Kevin Perrone of all medical issues during the health history interview. I understand that the session is not a replacement for medical evaluation and it is not Kevin Perrone's duty to diagnose any past or future medical conditions. All interactions before, during, and after the session are intended to be informative in nature and are not to replace or supersede any previous or future medical advice.
You acknowledge that you have carefully read this “waiver and release” and fully understand that it is a release of liability. You expressly agree to release and discharge the trainer or instructor from any and all claims or causes of action and you agree to voluntarily give up or waive any right that you may otherwise have to bring a legal action against the trainer or instructor for personal injury or property damage.
To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence.
If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions severed here from.
By signing this release, I acknowledge that I understand its content and that this release cannot be modified orally.
HAVING READ THE ABOVE TERMS AND INTENDING TO BE LEGALLY BOUND HEREBY AND UNDERSTANDING THIS DOCUMENT TO BE A COMPLETE WAIVER AND DISCLAIMER IN FAVOR OF Kevin Perrone OF ANY AND ALL LIABILITY, I HEREBY AFFIX MY SIGNATURE HERETO.