Total Athlete Performance – Verona Athletic Center
This form is an important legal document. It explains the potential risk associated with an exercise program as it relates to you or
your child. It is crucial that you read and understand it completely.
WAIVER & RELEASE OF LIABILITY
I have volunteered to participate in a program of physical exercise under the direction of TOTAL ATHLETE PERFORMANCE LLC which will include, but may not be limited to, weight (resistance) training, assorted games, movement, flexibility, and other assorted exercise skills and drills (i.e. jumping, running, skipping, hopping, throwing, rolling, bouncing, etc.). In consideration of TOTAL ATHLETE PERFORMANCE LLC agreement to instruct, assist, and train (Child’s Name), I, on behalf of myself, my heirs, and executors, covenant not to sue TOTAL ATHLETE PERFORMANCE LLC, and do here and forever release and discharge and hereby hold harmless TOTAL ATHLETE PERFORMANCE LLC respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present of future, arising out of or connected with my participation in this or any exercise program including any injuries resulting there from.
SOCIAL MEDIA RELEASE
Total Athlete Performance has permission to use my child’s photograph and future video footage for use in various media outlets. I understand that the images may be used in print publications, online publications, presentations, websites, and social media platforms. I also understand that no royalty fee or other compensation shall become payable to me by reason of such use.
ASSUMPTION OF RISK
I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of certain unusual physical changes during exercise does exist. These changes include, but are not limited to, abnormal blood pressure, fainting, disorders in heartbeat, heart attack, and in extremely rare instances, death.
Although, trainer will take precautions to ensure safety, I expressly assume and accept sole responsibility for my safety. I understand that as
a result of my participation in an exercise program, my child could suffer any injury or physical disorder that could result in becoming
partially or totally disabled and incapable of performing any gainful employment or having a normal social life.
I recognize that all participants prior to involvement in any exercise program should obtain an examination by a physician. If I have chosen not to obtain a physician’s permission prior to beginning this exercise program with TOTAL ATHLETE PERFORMANCE LLC, I hereby agree that I am doing so at my own risk.
In all cases, circumstances, situations, events and locations, I acknowledge and agree that I assume the risks associated with any and all
activities and/or exercises in which my child participates.
I acknowledge and agree that no warranties or representations have been made to me or my child regarding the results will achieve from
this program. I understand that results are individual and may vary.