Bodies by Bashay Waiver and Release

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Please complete and submit this form prior to any exercise activity with Wayne Bashay/Bodies by Bashay/River Market Boot Camp.

This WAIVER AND RELEASE shall be governed by the laws of the State of Arkansas and the courts located in Pulaski County. Arkansas shall have the exclusive jurisdiction for any action arising there from. Before registering and participating in any physical exercise activity with Wayne Bashay/Bodies by Bashay/River Market Boot Camp, every person and his/her parent or legal guardian (if the person is under 18 years of age) should read this WAIVER/RELEASE. By electronically signing this form, the person and/or his/her parent or guardian signifies that he/she has read the information contained in this WAIVER/RELEASE, fully understands this information and agrees to the terms contained herein. INCLUDED IN THESE TERMS ARE A WAIVER AND RELEASE OF LIABILITY FOR PERSONAL INJURIES AND LOSS OF PERSONAL PROPERTY SUFFERED BY THE PARTICIPANT AND PERMISSION TO USE PARTICIPANT’S LIKENESS OR PHOTO.

I. VOLUNTARY WAIVER AND RELEASE

I understand that physical exercise can be strenuous and subject to risk of serious injury, you are urged to obtain a physical examination from a doctor before participating in any exercise activity. I agree that if I engage in any physical exercise or activity, I do so entirely at my own risk.

Any recommendation for changes in diet including the use of food supplements and weight reduction products are entirely my responsibility, and I agree that I should consult a physician prior to undergoing any dietary or food supplement changes. I agree that I am voluntarily participating in these activities and assume all risks of injury, illness or death.

This waiver and release of liability includes, without limitation, all injuries which may occur as a result of: (a) my participation in any activity or personal training session and (b) instruction, training, supervision, or dietary recommendations by my Personal Trainer, Wayne Bashay/Bodies by Bashay/River Market Boot Camp.

II. PERMISSION TO USE PHOTO

I hereby GRANT FULL PERMISSION to Wayne Bashay/River Market Boot Camp, to record any and all of my participation in this event for photos, motion pictures, television, radio, recordings, videotapes, and other media known and unknown, and to use them, no matter by whom taken, in any manner for publicity, promotions, advertising, trade or commercial purposes, without any reimbursements or fees of any kind due to me.

III. ACKNOWLEDGEMENT

I acknowledge that I have carefully read this “waiver and release” and fully understand that it is a release of liability. I expressly agree to release and discharge Wayne Bashay/Bodies by Bashay/River Market Boot Camp, my Personal Trainer from any and all claims or causes of action, and I agree to voluntarily give up or waive any right that I may otherwise have to bring a legal action against Wayne Bashay/Bodies by Bashay/River Market Boot Camp, my Personal Trainer, for personal injury or property damage.

To the extent that statute or case law does not prohibit release for negligence, this release is also for negligence on the part of Wayne Bashay/Bodies by Bashay/River Market Boot Camp, Personal Trainer.

If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions severed here from.

By electronically signing this release, I acknowledge that I understand its content and that this release cannot be modified orally.

I understand that typing my full name in this box constitutes a legal signature confirming that I acknowledge and agree to the understandings above. *

ENTER FULL NAME

MINOR RELEASE: I am the parent/guardian for the minor(s) listed below. I authorize my minor(s) to participate and be personally trained by Wayne Bashay/Bodies by Bashay/River Market Boot Camp under this release. I understand that typing my full name below and typing my minor(s) full name next to mine constitutes a legal signature confirming that I acknowledge and agree to the understandings above.

ENTER FULL NAME/MINOR(S) NAME (skip this section if it doesn't apply)

DATE *

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