In making the voluntary request to receive services provided by Mobilis, I agree to the following:
I fully understand and acknowledge that (a) the activities in which I will engage in as part of the
treatment, physical therapy, personal training, and/or fitness
classes (zoom and in studio) provided by Mobilis as well as the equipment used in said treatments, have inherent risks, dangers, and hazards; (b) my participation in such activities and/or use of such
equipment may result in injury or illness including, but not limited to bodily injury, disease, strains,
fractures, partial and/or total paralysis, death or other ailments that, could cause serious disability;
(c) these risks and dangers may be caused by the negligence of the representatives or
employees of Mobilis, the negligence of the participants, the negligence of others, accidents,
breaches of contract, or other causes. By my participation in these activities and use of
equipment, I hereby assume all risks and dangers and all responsibility for any losses and/or
damages whether caused in whole or in part by the negligence or the conduct of the
representatives or employees of Mobilis, or by any other person.
I, on behalf of myself, my personal representatives and my heirs, hereby voluntarily agree to
release, waive, discharge, hold harmless, defend, and indemnify Mobilis and their
representatives, employees, and assigns from any and all claims, actions or losses for bodily
injury, property damage, wrongful death, loss of services or otherwise which may arise out of
my use of any equipment or participation in these activities. I specifically understand that I am
releasing, discharging, and waiving any claims or actions that I may have presently or in the
future for the negligent acts or other conduct by the representatives or employees of Mobilis.
I HAVE READ THE ABOVE WAIVER AND RELEASE AND BY SIGNING IT AGREE. IT IS MY
INTENTION TO EXEMPT AND RELIEVE MOBLIS FROM LIABILITY FOR PERSONAL
INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR
ANY OTHER CAUSE.
