
Waiver and Release of Liability
Release of Liability, Waiver of Claims, Assumption of Risk, Indemnity Agreement, and Jurisdiction Agreement BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE.
Participants Name: the undersigned
TO:
Owners, coaches, volunteers, directors, officers, employees, trainers,
instructors, agents, officials, independent contractors, servants,
representatives, successors and assigns (herein after referred to as “DDW
Fitness”).
DEFINITIONS:
In this agreement:
a) The term “ATHLETIC ACTIVITY” OR
“ATHLETIC ACTIVITIES” includes but is not limited to online coaching, personal training, small group classes, competitions, fitness assessments, use of
facilities supervised or unsupervised, observation of athletic activities,
Olympic lifting, power-lifting, running, gymnastics,
strength conditioning, metabolic conditioning, plyometric, stretching, sports, and
programs, seminars/ workshops and services provided to the client by Bread & Butter Athletic.
b) The term “INJURY” shall refer to
all forms of physical, mental, and emotional injury in any way related to
athletic activity and transportation activities including, but not limited to:
death, breaks, strains, lacerations, dislocations, exercise induced
rhabdomyolisis, heart failure, concussion, frostbite, hypothermia, heat
illness, dehydration, trauma, anxiety, and fears.
DISCLAIMER:
Bread & Butter Athletic and representatives are not responsible for any death, injury, loss, or damage of any kind
suffered by any person while using Bread & Butter Athletic facilities or following the Bread & Butter Athletic program. I am aware that athletic activities
have inherent dangers and risks including but not limited to the potential for
serious personal injury or death caused by any athletic activities or any
condition of the facilities, equipment or online program of Bread & Butter Athletic some of which include:
a. Transient light-headedness,
fainting, abnormal blood pressure, chest discomfort, muscle cramps, muscle
soreness, pain, discomfort, fatigue, nausea, heart failure, exercise induced
rhabdomyolisis, and so forth;
b. All manner of injury resulting
from slipping or falling, while jumping, hopping, skipping,
running, walking, lifting, climbing, and impacting against the floor, walls,
equipment, other clients, or any permanent or temporary fixtures or equipment;
c. Abrasion, entanglement,
lacerations, bruising, dislocation, and other injuries resulting from
activities on or near racks, weight bars, pull up bars, walls, medicine balls, plyo boxes, outdoor facilities or other fitness facilities.
d. Injuries resulting from falling
athletes or objects such as weights, dumbbells, bars, medicine balls and so forth or by any objects dropped by other persons conducting athletic
activities or assisting others;
e. Failure of the equipment, racks,
stands, bars, attachments, anchor. And, I do hereby further
acknowledge and agree;
f. That the athletic
activities I am participating in requires a moderate to high degree of effort,
are designed to be high intensity, and are intended to maximally challenge my
cardiovascular endurance, stamina, strength, flexibility, speed, power,
coordination, agility;
g. That I will honestly represent my
level of fitness, health, nutrition, use of medication, medical history, and
current physical, mental, and medical condition to Bread & Butter Athletic;
h. That although Bread & Butter Athletic takes
steps to reduce the risks and increase the safety of all athletic activities,
it is not possible for Bread & Butter Athletic to make these athletic activities completely
safe, particularly if following the program online;
i. That I am personally responsible
for my preparation prior to athletic activities, my concentration and attention
during these athletic activities, and for my post activity rest and recovery;
j. That I will learn and obey the
rules and regulations of Bread & Butter Athletic while supervised or unsupervised, and that
I will follow the instructions and directions of Bread & Butter Athletic during
athletic activities;
k. That I will inform Bread & Butter Athletic immediately should I feel any pain, discomfort, fatigue, nausea or
other symptoms that I may suffer during and immediately after athletic
activities or that I will update my medical information and inform Bread & Butter of changes to my health if following the online program;
l. That I may stop participating at
any time and that I may be directed to stop by Bread & Butter Athletic should I display
noticeable signs of distress;
m. That I consent to receive first
aid and medical treatment by Bread & Butter Athletic in the event of an accident, injury or
illness during athletic activity;
n. That Bread & Butter Athletic may videotape,
audiotape, or photograph or share posts on social media of you for instructional and promotional purposes without
payment of any kind to you and without further notice to you or permission from
you.
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RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISK, INDEMNITY AGREEMENT AND JURISDICTION AGREEMENT
In consideration of Bread & Butter Athletic allowing me to participate in Athletic Activities, and for other
good and valuable consideration, the receipt and sufficiency of which is
acknowledged, I hereby agree as follows:
1. TO WAIVE ANY AND ALL CLAIMS that I have
or may have in the future against their owners, employees or representatives (all of whom are
herein after referred to as the “RELEASEES”) and TO RELEASE THE RELEASEES from
any and all liability for any loss, damage, expense or injury including death
that I may suffer or that my next of kin may suffer as a result of my
participation in athletic activities, DUE TO ANY CAUSE
WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY
STATUTORY OR OTHER DUTY OF CARE, ON THE PART OF THE RELEASEES, AND INCLUDING
THE FAILURE ON THE PART OF THE RELEASEES TO SAFEGUARD OR PROTECT ME FROM THE
RISKS, DANGERS AND HAZARDS OF ATHLETIC ACTIVITIES;
2. TO HOLD HARMLESS AND INDEMNIFY THE
RELEASEES from any and all liability for any property damage or personal injury
to any third party resulting from my participation in Athletic Activities or online program;
3. TO HOLD HARMLESS AND INDEMNIFY THE
RELEASEES from any and all liability for any costs they may incur for medical
costs, emergency transportation, and litigation resulting from my participation
in Athletic Activities or online program;
4. That this Agreement shall be
effective and binding upon my heirs, next of kin, executors, administrators,
assigns and representatives, in the event of my death or incapacity;
5. This Agreement and any rights, duties
and obligations as between the parties to this Agreement shall be governed by
and interpreted solely in accordance with the laws of NSW Australia and no
other jurisdiction; and
6. Any litigation involving the
parties to this Agreement shall be brought solely within NSW and shall be
within the exclusive jurisdiction of the Courts of NSW.
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I have read and
understood the foregoing assumption of risk, and release of liability and I understand
that by signing it obligates me to indemnify the parties named for any
liability for injury or death of any person and damage to property caused by my
negligent or intentional act or omission. I understand that by signing this
form I am waiving valuable legal rights.
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In entering into this Agreement I am not relying on any oral or written representations or statements made by Bread & Butter Athletic with respect to the safety of athletic activities other than what is set forth in this Agreement.
I CONFIRM THAT I AM THE FULL AGE OF EIGHTEEN (18) YEARS AND I HAVE READ AND UNDERSTOOD THIS AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST Bread & Butter Athletic.
Privacy and protection of information: WE WILL NOT SELL OR RELEASE YOUR PERSONAL INFORMATION.
This agreement must be completed in full, initialled where indicated, dated, signed and witnessed prior to participating in any athletic activities.
the undersigned