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BBC Waiver

In consideration of my being permitted to participate in weight lifting and any other activities offered by BROWARD/BOYNTON BARBELL CENTER LLC (the Company) or any other activity provider on or about the property (Property) located at 840 E Oakland Park Blvd, Suite 106, Fort Lauderdale, FL 33334 or 2950 NW Commerce Park Dr, Unit 8. Boynton Beach, FL 33426 (collectively, the Activity), I hereby agree to, intend to be bound by and understand that the Released Parties (as hereinafter defined) will rely upon, all of the following terms and conditions of this Release, Consent and Waiver (this Release):

WAIVER AND RELEASE:  I absolutely, unconditionally and forever waive, release, remise and discharge any and all actions, claims, proceedings, investigations, damages, losses, liabilities, costs and expenses of any type or nature (Claims) that I may now or hereinafter have or be entitled to assert against the Company, any owner, lessor or co-tenant at the Property, and/or all directors, officers, owners, affiliates, employees, agents, successors and assigns of the foregoing (collectively, the Released Parties), which are based on, arise out of or in any way relate to (a) my participation in the Activity, whether occurring before, during or after the Activity, including without limitation claims based on any condition existing on or about the Property or the negligent acts or omissions of any Released Party or any third party; or (b) the breach of any representation, warranty or covenant made by me herein (all of the Claims described in this paragraph are collectively, Released Claims), and I covenant not to sue any of the Released Parties for any such Released Claims; provided that a Released Party shall not be released from any Claim which has been determined by a court of competent jurisdiction to have been directly based on or arising from the gross negligence or willful misconduct of such Released Party, and the foregoing covenant not to sue shall not apply in such instance.    

INDEMNITY/INSURANCE:   I will indemnify, defend and hold harmless each Released Party from and against any and all Released Claims; provided that that a Released Party shall not be entitled to indemnification for any Claim which has been determined by a court of competent jurisdiction to have been directly based on or arising from the gross negligence or willful misconduct of such Released Party.  I am not relying on the Released Parties to have arranged for, or carry, any insurance of any kind for my benefit or the benefit of any Released Party or third party relative to my participation in the Activity and/or my obligations under this Release.  I am solely responsible for obtaining, at my sole cost and expense, any life, disability, health, accident, property, or other insurance related to my participation in the Activity and the performance of my obligations pursuant to this Release.

ASSUMPTION OF RISKS: I understand that incidental to my participation in the Activity, I may be engaging in activities that involve the risk of serious personal injury, illness, permanent disability, dismemberment, and death, and that such participation may also involve the risk of severe economic and property loss and damage. I understand that these risks may result from the actions, negligence and failure to act of myself and others (including but not limited to other individuals in attendance at the Activity and the Released Parties) and from the condition of any property, facilities or equipment used. I also understand that there may be risks involved which are not known to me or to the Released Parties, and may not be foreseen or reasonably foreseeable by any of us at this time or at the time of the Activity. I agree to assume all of the foregoing risks, which risks may include, among other things, muscle injuries and broken bones, as well as the risk of any negligence by other participants or by the Released Parties, and the risk of injury caused by the condition of any property, facilities or equipment used during the Activity, and accept personal responsibility for any injury (including, but not limited to, personal injury, disability, dismemberment and death), illness, damage, loss, claim, liability, or expense, of any kind or nature, that I or my property may suffer arising out of or in connection with my participation in the Activity.

 

 

PHYSICAL CONDITION/MEDICAL AUTHORIZATION: I represent and warrant to the Released Parties that I am physically fit for participation in the Activity and have the skill level required in conjunction with the Activity, and have not been advised otherwise. In the event I suffer any injury, illness or medical conditions while present on the property where the Activity is conducted, I hereby authorize and shall be financially responsible for the cost of, any emergency first aid, medication, medical treatment or surgery deemed necessary by the attending medical personnel.  Notwithstanding the foregoing, I acknowledge that the Released Parties shall have no duty, obligation or liability arising out of the provision of, or failure to provide, medical treatment.

EQUIPMENT AND FACILITIES INSPECTION:  I represent, warrant and covenant to and with the Released Parties that (a) I have inspected, or will inspect, all facilities and equipment prior to my participation in the Activity, (b) I am not aware of any unsafe conditions or conduct on or about the Property; and (c) I will immediately advise a Company  manager/supervisor of any unsafe condition or conduct observed and will not participate in any Activity until any such unsafe condition or conduct observed by me has been remedied.

GOVERNING LAW: This Release shall be governed by the laws of the State of Florida, and any legal action relating to or arising out of my participation in the Activity shall be commenced exclusively in the Circuit Court of the Fifteenth Judicial Circuit in and for Palm Beach County, Florida (or if such Circuit Court shall not have jurisdiction over the subject matter thereof, then to such other court sitting in such county and having subject matter jurisdiction), AND I SPECIFICALLY WAIVE THE RIGHT TO TRIAL BY JURY.

INTERPRETATION: This Release is intended to be as broad and inclusive as permitted by law, and that if any provision of this Release is held by any court of competent jurisdiction to be illegal, invalid or otherwise unenforceable, the enforceability of the remaining provisions shall not be impaired thereby, and such invalid part, term or provision shall not be deemed part of this Release unless the same shall have been reformed by such court to reflect the original intent as nearly as possible in accordance with applicable law.  Any ambiguities in this Release shall not be construed in favor or against any party by virtue of that party having drafted the Release.

By signing below, I represent and warrant to the Released Parties that: (a) I have fully and completely read, understand, consent to and agree with all of the provisions of this Release; (b) I am 18 years of age or older; (c) all personal information furnished by me on this form is true, accurate and complete.  I acknowledge that, while execution of this Release is required as a condition of my participation in the Activity, my participation in the Activity is voluntary.  Further, I understand that the Released Parties are specifically relying upon the waivers, releases, covenants, representations and warranties provided by me in this Release as a condition of allowing me to participate in the Activity.

 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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