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Mat Rental Participant Liability Waiver

for

Powestation Gym / Prodigy

Mat Rental Participant Liability Waiver

for

Powestation Gym / Prodigy

READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS!

This Release and Waiver of Liability ("Release") executed on this day by the Participant in favor of Powerstation Training LLC and Powerstation Gym LLC, doing business as Powerstation Gym and Sports Training henceforth known as“”Powerstation” and Prodigy Wrestling Academy, LLC henceforth known as “Prodigy” with offices at 4343 South Dixie Highway, Middletown Ohio 45005, and their directors officers, employees, and agents.

December 11, 2018

1. Acknowledgement of Risk. Participant understands and acknowledges that all exercises, including the use of weights and use of any and all machinery, equipment, and apparatus designed for exercise shall be at the members’ sole risk. The Participant also understands and acknowledges that all programs and classes offered by and through “Powerstation/Prodigy”, and that fitness classes, and even self-monitored activities in which Participant desires to engage (the “Activities”) while on the premises of “Powerstation/ Prodigy” entail certain risks. “Powerstation/Prodigy” urges you and all members to obtain a Physical examination from a doctor before using any exercises equipment, machinery, or participating in any exercise or training class. Participant acknowledges that while the staff of “Powerstation/Prodigy”, have been trained to protect physical safety, participation is purely voluntary.

2. Assumption of Risk. Participant understands the agreement to use or selection of programs, classes, trainings, methods, and types of equipment shall be the participants’ sole responsibility. Activities may involve indoor or outdoor activities and or training, physical exertion, use of mechanical equipment, exposure to hazardous conditions, or other circumstances that may be hazardous. Participant hereby expressly and specifically assumes the risk of injury or harm in the Activities, and releases “Powerstation/Prodigy”, from all liability for injury, illness, death, or property damage resulting from the Activities.

3. Release and Waiver. Participant freely, voluntarily, and without duress, elects to participate in spite of the associated risk, and by signing this Release, knowingly and voluntarily assumes all responsibility for participation. Participant does hereby release and forever discharge and hold harmless “Powerstation/Prodigy”, and its successors and assigns from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, that arise or may hereafter arise from Participant's Activities with “Powerstation/Prodigy”. Participant understands this releases “Powerstation/Prodigy” from any liability or claim the volunteer may have against “Powerstation/Prodigy” with respect to any bodily injury, psychological or emotional injury, personal injury, illness, death or property damage that may result from the Activities, whether caused by the negligence of “Powerstation/Prodigy” or its officers, directors, employees or agents, or otherwise. Participant also understands “Powerstation/Prodigy”, does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of injury, illness.

4. Medical Treatment. Participant does hereby release and forever discharge “Powerstation/Prodigy”, from any claim whatsoever which arises or may hereafter arise on account of any first aid, treatment, or service rendered in connection with the Activities.

5. Media Release. Participant does hereby grant and convey unto Powerstation/Prodigy” all right, title, and interest in any and all photographic images and video or audio recordings made by, or on behalf of “Powerstation/Prodigy” during the Activities and while on the premises of “Powerstation/Prodigy”, including, but not limited to, any royalties, proceeds, or other benefits derived from such photographs or recordings.

6. Other. Participant expressly agrees that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Ohio, and that this Release shall be governed by and interpreted in accordance with the laws of the State of Ohio. Participant also agrees that in the event any clause or provision of this Release shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provisions of this Release which shall continue to be enforceable.

IN WITNESS WHEREOF, Participant has execute this Release as of the day and year first above.

If Participant is younger than 18 years old, this Release must be executed on their behalf by a parent or guardian.

Today's Date: December 11, 2018

First Participant's Name

First Name*

Last Name*
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*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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*
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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