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 Waiver and Release of Liability
Alphalete Gym LLC
711 Avenue E
Stafford, Texas 77477

 

In consideration for the license to utilize the exercise equipment and facilities located at 711 Avenue E, Stafford, Texas (the “Premises”) provided by Alphalete Gym Limited Liability Company, on behalf of itself and its subsidiaries and affiliates (collectively referred to as the “Company”), I expressly agree and contract, on behalf of myself, my heirs, executors, administrators, successors and assigns, that the Company and its insurers, employees, officers, directors, and associates, shall not be liable for any damages arising from personal injuries (including death) sustained by me, or my guest in, on, or about the Premises, or as a result of the use of the equipment or facilities, regardless of whether such injuries result, in whole or in part, from the negligence of the Company. By the execution of this agreement, I accept and assume full responsibility for any and all injuries, damages (both economic and non-economic), and losses of any type, which may occur to me or my guest, and I hereby fully and forever release and discharge the Company, its insurers, employees, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising out the use of said equipment and the Company’s facilities. I expressly agree to indemnify and hold the Company harmless against any and all claims, demands, damages, rights of action, or causes of action, of any person or entity, that may arise from injuries or damages sustained by me or my guest.

I agree to be solely responsible for safety and well-being of my guest and myself. I understand that the Company does not provide supervision, instruction, or assistance for the use of the facilities and equipment.

In the event I engage a personal trainer to provide me fitness and/or health training at the Premises, I acknowledge and understand that such personal trainer is not an employee or agent of the Company. I acknowledge the Company has not and does not review the exercise and/or fitness regime of any personal trainer at the Premises. I agree to be solely responsible for reviewing the credentials and qualifications of any personal trainer I utilize at the Premises. I expressly agree and contract, on behalf of myself, my heirs, executors, administrators, successors and assigns, that the Company and its insurers, employees, officers, directors, and associates, shall not be liable for any damages arising from personal injuries (including death) sustained by me, or my guest in, on, or about the Premises, or as a result of the use of the equipment or facilities, regardless of whether such injuries result, in whole or in part, from the negligence of any personal trainer utilized by myself or my guests. By the execution of this agreement, I accept and assume full responsibility for any and all injuries, damages (both economic and non-economic), and losses of any type, which may occur to me or my guest, and I hereby fully and forever release and discharge the Company, its insurers, employees, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising of such personal trainer’s negligence. I expressly agree to indemnify and hold the Company harmless against any and all claims, demands, damages, rights of action, or causes of action, of any person or entity, that may arise from injuries or damages sustained by me or my guest as result of such personal trainer’s negligence. 


I agree to comply with all rules imposed by the Company regarding the use of the facilities and equipment at the Premises. I agree to conduct myself in a controlled and reasonable manner at all times, and to refrain from using any equipment in a manner inconsistent with its intended design and purpose.

I understand and acknowledge that the use of exercise equipment involves risk of serious injury, including permanent disability and death.

I understand and agree that the Company is not responsible for property that is lost, stolen, or damaged while in, on, or about the Premises.

 

By signing this release form I authorize Alphalete Athletics to use the following personal information: 

(1) My picture – including photographic, motion picture, and electronic (video) images. 

(2) My voice – including sound and video recordings. 

I hereby grant to Alphalete Athletics Gym its subsidiaries, licensees, successors and assigns, the right to use, publish, and reproduce, for all purposes, my name, pictures of me in film or electronic (video) form, sound and video recordings of my voice, and printed and electronic copy of the information described in sections (1) and (2) above in any and all media including, without limitation, cable and broadcast television and the Internet, and for exhibition, distribution, promotion, advertising, sale, press conferences, meetings, hearings, educational conferences, social media platforms, and in brochures and other print media. This permission extends to all languages, media, formats and markets now known or hereafter devised. This permission shall continue forever unless I revoke the permission in writing.

I further grant Alphalete Athletics Gym and its subsidiaries, licensees, successors and assigns all right, title, and interest that I may have in all finished pictures, negatives, reproductions, and copies of the original print, and further grant Alphalete Athletics Gym the right to give, sell, transfer, and exhibit the print in copies or facsimiles thereof, for marketing, communications, or advertising purposes, as it deems fit. 

I hereby waive the right to receive any payment for signing this release and waive the right to receive any payment for Alphalete Athletics Gym’s use of any of the material described above for any of the purposes authorized by this release. I also waive any right to inspect or approve finished photographs, audio, video, multimedia, or advertising recordings and copy or printed matter or computer generated scanned image and other electronic media that may be used in conjunction therewith or to approve the eventual use that it might be applied. 

I acknowledge that I have read the foregoing and I fully understand the contents.     

I HAVE READ THE FOREGOING WAIVER AND RELEASE OF LIABILITY AND VOLUNTARILY EXECUTED THIS DOCUMENT WITH FULL KNOWLEDGE OF ITS CONTENT.

 

First Guests Name

First Name*

Last Name*

Phone*
First Guests Date of Birth*
I certify that I am 18 years of age or older
First Guests Signature*
Second Guests Name

First Name*

Last Name*
Second Guests Date of Birth*
Second Guests Signature*
Third Guests Name

First Name*

Last Name*
Third Guests Date of Birth*
Third Guests Signature*
Fourth Guests Name

First Name*

Last Name*
Fourth Guests Date of Birth*
Fourth Guests Signature*
Fifth Guests Name

First Name*

Last Name*
Fifth Guests Date of Birth*
Fifth Guests Signature*
Sixth Guests Name

First Name*

Last Name*
Sixth Guests Date of Birth*
Sixth Guests Signature*
Seventh Guests Name

First Name*

Last Name*
Seventh Guests Date of Birth*
Seventh Guests Signature*
Eighth Guests Name

First Name*

Last Name*
Eighth Guests Date of Birth*
Eighth Guests Signature*
Ninth Guests Name

First Name*

Last Name*
Ninth Guests Date of Birth*
Ninth Guests Signature*
Tenth Guests Name

First Name*

Last Name*
Tenth Guests Date of Birth*
Tenth Guests Signature*
Guests Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
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*
I certify that I am 18 years of age or older
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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