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JSA3, LLC D/B/A CROSSFIT YARDS

WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK

By signing below you hereby acknowledge and agree that your use of JSA3, LLC d/b/a CrossFit Yards's ("CFY") facilities, services, equipment or premises, involves risks of injury to persons and property, including those described below, and you assume full responsibility for such risks.

Waiver, Release and Assumption of Risk. In consideration of being permitted to enter the facility and participate in the activities of CFY for any purpose including, but not limited to, observation, use of facilities, services or equipment or participation in any way, you agree to the following: You hereby release and hold CFY, its members, officers, employees, trainers and agents harmless from all liability to you and your personal representatives, assigns, heirs and next of kin for any loss or damage, and forever give up any claim or demand therefore, on account of injury to your person or property, including injury leading to your death, whether caused by the active or passive negligence of CFY or otherwise, to the fullest extent permitted by law, while you are in, upon, or about CFY 's premises, participating in a CFY workout, or using any of CFY 's facilities, services or equipment. You also hereby agree to indemnify CFY from any loss, liability, damage or cost CFY may incur due to your presence in, upon or about the CFY premises or in any way observing or using any facilities or equipment of CFY whether caused by your negligence or otherwise.

Activities. You acknowledge that the training programs you will be participating in, and that are offered by CFY, involve strenuous physical activities, including, but not limited to, running, weight training, rowing, gymnastic-type/bodyweight movements, and various aerobic and anaerobic conditioning and strength training using functional movements executed at high intensity (the “Physical Activities”). You acknowledge these Physical Activities involve the inherent risk of death, physical injuries or other damages, including, but limited to: heart attacks; muscle strains; pulls or tears; broken bones; shin splints; heat exhaustion; knee, back and foot injuries; general illness; infections; and soreness. You further acknowledge that such risks may be caused by your negligence, the negligence of an instructor, other participant, CFY 's landlord or other related persons, defective or improperly used or installed equipment, overexertion, slip and fall, or a known or unknown health problem. Additionally, you acknowledge that during the participation in the Physical Activities you may leave the physical premises of CFY. You 2 acknowledge the risk of running or exercising in a publicly accessible parking lot and/or public street. Accordingly, you agree to abide by all applicable traffic and other laws or rules.

Health Representations. You represent (a) that you are in good physical condition and have no disability, illness, or other condition that could prevent you from exercising without injury or impairment of health, and (b) that you have consulted a physician concerning participating in a exercise program in the type offered by CFY and that such participation will not risk injury or impair your health.

Scope of Release, Waiver and Indemnity. You further expressly agree that the foregoing release, waiver and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the Commonwealth of Pennsylvania and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full force and effect. You have read this release and waiver of liability and indemnity clause, and agree that no oral representations, statements or inducement apart from this Agreement have been made.

Photo/Video Authorization and Release. I hereby grant CFY permission in perpetuity to use my photograph/video image in any and all publications for CrossFit Inc. or CFY, including web site entries, without payment or any other consideration or remuneration. I hereby authorize CFY to edit, alter, copy, exhibit, publish or distribute all such photos, images and video without restriction. I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photographs or video images. I hereby hold harmless and release and forever discharge CFY from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf, or on behalf of my estate, may have by reason of this Photo/Video authorization and release.

Date: April 23, 2019

First Client's Name

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First Client's Date of Birth*
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Second Client's Name

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Second Client's Date of Birth*
Third Client's Name

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Third Client's Date of Birth*
Fourth Client's Name

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Fourth Client's Date of Birth*
Fifth Client's Name

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Fifth Client's Date of Birth*
Sixth Client's Name

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Sixth Client's Date of Birth*
Seventh Client's Name

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Seventh Client's Date of Birth*
Eighth Client's Name

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Eighth Client's Date of Birth*
Ninth Client's Name

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Ninth Client's Date of Birth*
Tenth Client's Name

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Tenth Client's Date of Birth*
Parent or Guardian's Email Address

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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*
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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