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Extreme Studio Performance Adult Waiver/Release

RELEASE OF LIABILITY FOR PARTICIPANTS- READ BEFORE SIGNING

IN CONSIDERATION OF (I/Participant) being at least eighteen (18) years old and allowed to participate in any way at Extreme Studio Performance, LLC (“Extreme Studio Performance” or “Released Party) in the sports and fitness related events and activities occurring on the premises of Extreme Studio Performance located at 4335 McEwen Road, Dallas, Texas 75244 (the “Activities”), the undersigned acknowledges, appreciates, and agrees that:

The risk of injury to myself from the activities involved in these programs is significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist.

1) FOR MYSELF AND SPOUSE I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my participation.

2) I willingly agree to comply with Extreme Studio Performance’s stated and customary terms and conditions for participation in the Activities. If I observe any unusual significant concern in my readiness for participation and/or in the program itself, I will remove myself from the participation and bring such attention of the nearest official immediately.

3) I for myself, my spouse, my child/ward, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Extreme Studio Performance, its members, directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASED PARTY OR OTHERWISE, to the fullest extent permitted by law.

4) I UNDERSTAND AND ACKNOWLEDGE that the Activities in which my child/ward engages in are voluntary and bear certain anticipated and unanticipated risk which could result in injury, death, illness, disease, and/or physical or mental damage to myself, other persons and property. These risks include:

All risks inherent in the Activities, including risk of injury or damage to my person and property, death, dismemberment, disfigurement, an partial or total destruction of property;

The acts, omission, negligence, or fault in any degree of the Extreme Studio Performance;

Latent or apparent defects or conditions located at the premises of Extreme Studio Performance, equipment or property supplied by Extreme Studio Performance or other persons or entities at Extreme Studio Performance;

The condition of any exercise equipment, exercise machines, and property located at Extreme Studio Performance;

My own acts and omissions, as well as my physical condition and skill level, the acts or omissions of Extreme Studio Performance, and the acts or omissions of other persons engaging in the Activities; and

First aid, emergency treatment, or other services rendered by Extreme Studio Performance or others.

5) I UNDERSTAND AND ACKNOWLEDGE that the above list is not complete or exhaustive, and that other risk, known or unknown, identified or unidentified, anticipated or unanticipated, whether incurred during the course of any of the Activities, or otherwise at Extreme Studio Performance could also result in injury, death, illness, disease, or damage to myself, other persons, and property.

6) I agree to indemnify and hold Extreme Studio Performance including but not limited to its members, directors, officers, officials, agents, employees and volunteers harmless from and against any and all suits of any nature or kind caused by, resulting from or in any way connected with the Activities conducted on their premises whether or not caused by the active or passive negligence or other fault of Extreme Studio Performance.

7) I, for sufficient consideration, receipt of which is hereby acknowledged, hereby irrevocably grant Extreme Studio Performance, its successors, affiliates, and partners the right to record my likeness and/or voice on tape, film, or digital media, to edit such tape, film or digital media at its discretion; to incorporate the same into video, TV, radio, web or print advertisement or video; and to use or authorize the use of such tape, film, and videotape or any portion thereof in any manner or media at any time through the world in perpetuity and to use my likeness, biological information, and other information concerning me in connection therewith including promotion in all media. I hereby release Extreme Studio Performance and anyone using said film, digital image, or other material from any and all claims, damages, liabilities, costs, and expenses which I now have or may hereafter acquire by reason of any use thereof.

8) I UNDERSTAND AND ACKNOWLEDGE that no major medical or accident insurance benefits will be provided to me while engaging in any of the Activities. I certify that I have sufficient health, accident, and personal liability insurance to cover any bodily injury or property damage that I may incur while participating in the Activities, and to cover bodily injury or property damage caused to another party as a result of my participation in the Activities. If I have no such insurance, I certify that I am capable of personally paying for any and all such expenses and liability. I understand and acknowledge that the Activities require significant physical exertion and require the Participant to be in a healthy physical condition sufficient to handle the physical exertion required for the Activities. Participant acknowledges and agrees that Extreme Studio Performance shall have no obligation to judge or determine a Participant’s physical condition or ability to handle the physical requirements of the Activities. I FURTHER ACKNOWLEDGE that I am in good physical and mental health, and am not suffering from any condition, diseases or disablement that would or could potentially affect my participation in the Activities.

9) I, for myself, my spouse, my child/ward, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS the above Released Party from any and all liabilities incident to my involvement or participation in these programs and Activities, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Date Signed: November 20, 2018

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
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*
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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*
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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