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Texas Family D.R.E.A.M. Center, LLC
PLEASE READ, INITIAL AND SIGN THE RELEASE AGREEMENT
RELEASE & INDEMNITY AGREEMENT
THIS RELEASE AND INDEMNITY AGREEMENT (“Release”) is made by the undersigned adult (the “Participant or Participant’s guardian”), to release and indemnify Texas Family D.R.E.A.M. Center, LLC, a Texas limited liability company, and all of its respective members, employees, heirs, successors, agents, contractors, volunteers, and assigns as set forth below.
Participant, on Participant’s own behalf of the other members of the Participant’s family, including Participant’s spouse, parents, children, heirs, and assigns, (singularly and collectively referred to as “Participant”) hereby grants to the Institute this full release and indemnification as consideration in exchange for permitting Participant to participate in this program.
Participant is entering into this Release after having viewed or having the opportunity to view the facility; having reviewed the instructor’s qualifications; having had the scope of the services and associated risks explained; and having had an opportunity to ask questions regarding the services and risks associated with this program.
Participant is voluntarily participating in the activity with full knowledge, understanding and appreciation of the risks inherent in any physical exercise/activity and expressly assumes all risks of injury and even death which could occur by reason of participant's participation.
Participant releases Texas Family D.R.E.A.M. Center, LLC from any liability and agrees not to sue the Institute with respect to any cause of action for bodily injury, property damage, or death occurring to participant as result of participating in this program.
Participant hereby assumes full responsibility for risks of bodily injury, property damage, or death to participant due to the ordinary negligence or gross negligence of the Institute and the ordinary negligence, gross negligence, or willful misconduct of any third party including others participating in the program.
Participant agrees to indemnify, defend, and hold harmless, at Participant’s sole cost the Institute from any and all claims arising out of Participant’s participation in the program.
All personal property brought to the Institute is brought at the sole risk of the Participant as to its theft, damage, or loss.
Participant expressly agrees that the terms of release indemnity contained herein are intended to be as broad and inclusive as is permitted by the laws of Texas. Any provision of this Release found to be invalid by the courts having jurisdiction shall be invalid only with respect to such provision or portion.
______ I hereby grant Texas Family D.R.E.A.M. Center (hereinafter referred to as FDC) to take or have taken still and/or moving photographs and films including television pictures of (participant) ______________________________________ and consent and authorize FDC to use and reproduce the photographs, films and pictures, and to circulate and publicize the same, by all means including, but not limited to, website, social networking, newspapers, television media, brochures, pamphlets, instructional material, books and clinical material.
______I do NOT give my consent to Texas Family D.R.E.A.M. Center to take or have taken still and/or moving photographs and films including television pictures.
PARTICIPANT HAS READ AND VOLUNTARILY SIGNS THIS RELEASE AND INDEMNITY AGREEMENT.
Participant/Guardian Name: ______________________________________ Date: __________________
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