Fitness Waiver

Release and Waiver of Liability Agreement

For Participation in Barsh Fitness Classes

This agreement is by and between Candice Barsh (herein referred to as the fitness instructor) and the individual whose name is signed and printed below (herein referred to as the participant).

I, ______________________________________, hereby agree to the following:

I am participating in Barsh Fitness classes, offered by Candice Barsh and during which I will receive information and instruction about Barsh Fitness. I recognize that these classes require physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.

I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any of classes. I represent and warrant that I am physically fit and I have no medical condition that would prevent my full participation in these classes.

In the event of an emergency, I authorize medical attention from any licensed hospital, physician and/or medical personnel any treatment deemed necessary for my immediate care and agree that I will be responsible for any payment of any and all medical services rendered. Therefore, each person registering themselves or family member should review their own health insurance policy for coverage. It must be noted that the absence of health insurance coverage does not make Candice Barsh, Barsh Fitness or Aquilla ISD responsible for any payment of any medical expenses.

In consideration of being permitted to participate in these classes, I agree to assume full responsibility for any risks or injuries including death, damages, known or unknown regardless of severity, which I might incur as a result of activities associated with Barsh Fitness.

In further consideration of being permitted to participate in Barsh Fitness classes, I knowingly, voluntarily and expressively waive and relinquish any claims I may have against Candice Barsh and any other facility the classes may occur, including but not limited to, Barsh Fitness and Aquilla ISD, for damages and injury that I may sustain as a result of participating in these classes.

I, my heirs or legal representatives forever release, waive, discharge and covenant not to sue Candice Barsh, Barsh Fitness or Aquilla ISD for any injury or death caused by my voluntary participation in Barsh Fitness classes.

I understand and hereby acknowledge that I have read and reviewed the waiver and release form and hereby agree to be bound by the terms of this waiver and release form.