WAIVER AND RELEASE OF LIABILITY FORM FOR FIERCE FITNESS & DACE CO., NICOLE KENDALL AND ZUMBA WITH NICOLE KENDALL
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH ANY CLASSES AND INSTRUCTORS AT FIERCE FITNESS & DANCE CO., including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I certify that I as the parent or guardian of the student participation or I myself am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity.
I acknowledge that this Waiver and Release of Liability Form will be used by the event holders, sponsors, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity.
In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE from any and/or all liability of Nicole Kendall, Sole Proprietor of Fierce Fitness at 228 Ford Street Ogdensburg, or any designated location, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, abnormal blood pressure, heart attack, or actions of any kind which may hereafter occur to me including my traveling to and from this activity
(B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in the above paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.
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I understand while participating in this activity, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the activity holders, producers, sponsors, organizers, and assigns.
The Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.
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Participant’s Signature Date Participant’s Name Age
(Please sign legibly)
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Parent/Guardian Signature Date
(If under 18 years old, Parent or Guardian must also sign.)