Village Athlete LLC

Contact Sara:

sklandolt at yahoo dot com

Village Athletes must read and sign this Waiver 1x for the season.

VILLAGE ATHLETE LLC

PLEASE READ CAREFULLY BEFORE SIGNING ACKNOWLEDGMENT, WAIVER AND RELEASE FROM LIABILITY (AWRL)

I acknowledge that group exercise and bootcamp-style workouts carry potential for death, serious injury and property loss. I HEREBY ASSUME THE RISKS OF PARTICIPATING IN GROUP EXERCISE. I certify that I am physically fit, have sufficiently trained for participating in these workouts, and have not been advised against participation by a qualified health professional. I acknowledge that my statements on this AWRL are being accepted by Village Athlete LLC in consideration for allowing me to participate in any Village Athlete event.

In consideration for allowing me to participate in Village Athlete events, I hereby take the following action for myself, my executors, administrations, heirs, next of kin, successors and assigns, or anyone else who might claim or sue on my behalf, and I expressly acknowledge that it is my intent to take these actions: (a) I AGREE to follow the guidelines from Village Athlete, (b) I AGREE that if I believe something is unsafe I will immediately advise the workout leaders. (c) I WAIVE, RELEASE, AND DISCHARGE from any and all claims, losses or liabilities for death, personal injury, partial or permanent disability, property damage, medical or hospital bills, theft or damage of any kind, including economic losses, which may in the future arise out of or relate to my participation in or my traveling to and from a Village Athlete LLC event, THE FOLLOWING PERSONS OR ENTITIES: SARA LANDOLT, VILLAGE ATHLETE LLC, VOLUNTEERS, AND AGENTS OF ANY OF THE ABOVE, EVEN IS SUCH CLAIMS, LOSSES OR LIABILITIES ARE CAUSED BY THE NEGLIGENT ACTS OR OMISSIONS OF THE PERSONS I AM HEREBY RELEASING OR ARE CAUSED BY THE NEGLIGENT ACTS OR OMISSIONS OF ANY OTHER PERSON OR ENTITY; (d) I ACKNOWLEDGE that there may be traffic or persons on the roads, sidewalks, park area and I ASSUME THE RISK OF EXERCISE IN THESE AREAS. I also ASSUME ANY AND ALL OTHER RISKS associated with participating in Village Athlete LLC events including but not limited to falls, contact and/or effects with other participants, effects of weather, including heat and/or humidity, defective equipment, the condition of the roads, and any hazard posed by spectators, volunteers or pets and animals. All such risks being known and appreciated by me, I further acknowledge that these risks include risks that may be the result of negligence of the persons or entities mentioned above, (e) I AGREE NOT TO SUE any of the persons or entities mentioned in the above paragraph for any of the claims, losses or liabilities that I have waived, released or discharged herein; (f) I INDEMNIFY AND HOLD HARMLESS the persons or entities mentioned above from any and all claims made or liabilities assessed against them as a result of my actions or inactions, the actions, inactions or negligence of others, including those parties hereby indemnified, the conditions of the facility, park, equipment or areas where the event or activity is being conducted; (g) I GRANT PERMISSION for the use of my name and/or likeness relating to my participating in Village Athlete LLC and I WAIVE all right to any future compensation to which I may otherwise be entitled as a result of the use of my name or likeness.

I HEREBY AFFIRM THAT I AM EIGHTEEN 18 YEARS OR OLDER, I HAVE READ THIS DOCUMENT AND I UNDERSTAND ITS CONTENTS.

X_______________________________________________________ AGE:________

Date signed:_____________________________________

CONSENT & RELEASE OF PARENT OR GUARDIAN

This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my child and our heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless of the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law:

X__________________________________________________________________

PARENT/GUARDIAN’S SIGNATURE (print name) 

Date signed: ________________________