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SENSATION PLAYGYM, LLC PARTICIPANT AGREEMENT, WAIVER, RELEASE AND ASSUMPTION OF RISK, RELEASE OF LIABILITY AND CONSENT TO USE OF LIKENESS AND PHOTOGRAPHS

NOTICE: READ THIS FORM COMPLETELY AND CAREFULLY.

In consideration of being allowed to use the facility located at 49 Broadway, Fort Edward New York and to participate in the services and activities provided by owner and operator SENSATION PLAYGYM, LLC, its agents, owners, affiliates, members, directors, volunteers, landlord vendors, insurers, managers, officers, employees,representatives, successors, assigns, affiliated entities, heirs, personal representatives and all other persons, firms,or entities claiming by or through them, hereinafter known as the “Gym”, and my desire to participate in these activities and or services, I on behalf of myself, my spouse, my minor child(ren), my parent(s), my heirs, assigns, personal representative and estate minor child for whom I am appointed guardian, and on behalf of any minor on whose behalf I sign this Agreement, hereby acknowledge, affirm, and agree to the following:

(1)I agree to use the Gym and its facilities in a safe and responsible manner;

(2) I agree to abide by the Gym rules and instructions and the direction of the Gym employees and representatives, whereby I acknowledge that (i) those rules, instructions and directions are intended to promote the safety of both myself and others; (ii) my failure or refusal to abide by those rules, instructions and directions can lead to the immediate revocation of my right to use the Gym and its facilities without any right to refund of any payment made; and (iii) in the event of sickness, accident or injury, (a) I will immediately report myinjury to the Gym’s staff and under no circumstances will I leave the Gym without doing so, (b) I will cease allparticipation in Gym activities at the time of sickness, accident or injury, (c) I authorize the Gym employees and representatives to obtain and secure, on my behalf, emergency medical treatment and transportation, when deemed appropriate by the Gym employees and representatives, and (d) I agree to assume, at my expense, all costs of emergency medical treatment and transportation,

(3) I acknowledge, understand and appreciate that my participation in the ACTIVITIES entails known and unanticipated risks that could result in death, serious physical or emotional injury, paralysis, or damage to me, toproperty, or to third parties. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. The risks include, including without limitation: slipping and falling; collision withfixed objects or people; injuries caused by stepping on or falling on equipment or items that have fallen from or weredropped by myself or another participant; injuries including spraining, fractures, scrapes, bruises and cuts, dislocations, pinched fingers and serious injuries to the head, back or neck, injuries arising out of the negligence ofor otherwise caused by other participants or myself; injuries due to my own physical or mental condition I may havewhether known or unknown; injuries due to physical contact with others, including the risk of contracting illness orcoming into contact with germs, bacteria or fungi whether by contact with equipment or with another participant, andany and all risks associated with exercise, physical exertion and physical activities (hereinafter referred tocollectively as “RISKS”)

(4)I expressly agree and promise to accept and assume all of the RISKS. My participation in activities at the Gym is purely voluntary, and I elect to participate in spite of the RISKS.

(5)I agree to and voluntarily do fully and forever waive, release, discharge, and indemnify and hold harmless Gym from any and all claims, actions, causes of action, demands, judgments, damages(including compensatory, general, special, consequential, exemplary and punitive) liability or obligation of anynature or kind, whether known at the time I leave the Gym or which may arise or become known later, which accrue on account of, or in any way arise out of or in connection with; (a) my activities within the Gym; (b) the activitieswithin the Gym by others; (c) the operation of the Gym by the Gym owners regardless of whether such claims arefounded in whole or in part upon alleged negligence, or the actual negligence of Gym Owner; (d) my use of any andall of the Gym facilities; (e) my use of any and all equipment within the Gym, whether owned by me, Gym Owner or1
a third party (f) my child/minor or wards use or participation at the gym and its equipment and facilities. Iunderstand that this perpetual release/waiver will apply to each and every occasion that I or my child/minor/ward visits the Gym;

(6)I agree to indemnify and hold Gym Owner harmless from and against any and all losses, liabilities, claims, obligations, costs, damages, and /or expenses whatsoever, including, but not limited to, anyand all attorneys fees, costs, damages and/or judgments directly or indirectly arising out of, or relating to my acts oromissions while participating in any activities at the Gym;

(7)I agree to accept and assume all of the risks which accompany the Gym’s activities and represent that my participation in the activities are purely voluntary and I elect to participate in theactivities notwithstanding the risks.

(8)I fully understand that participating in the activities within the Gym involve physical exertion; and accordingly represent that I (i) am in sufficient good health to participate in activities within the Gym;(ii) I do not have any pre- existing physical or medical condition, including without limitation pregnancy, orthopedic problems, including back problems; heart problems; and/or breathing problems, that might be impacted or worsened by my use of the Gym; and (iii) will not use the Gym and its facilities with under the use of any drugs,alcohol or medications that may impair my physical abilities or judgment;

(9)I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating in the activities within the Gym, or if not, I agree to bear the costs of such injury ordamage to myself and others; and,

(10)I authorize Gym to capture my image, likeness and sounds in photographs, videotapes, recordings or other forms of media (“Images”). I acknowledge that Gym will own such Images and I grant permission, without compensation, for Gym or any affiliated party of the SENSATION PLAYGYM, LLC brand to copyright, display, publish, distribute, use, modify and print such Images in any lawful manner, including without limitation, in publication, advertisements, brochures, website, social media and other electronic displays and transmissions thereof. The foregoing authorization shall not include using my name with any Image, unless I agree otherwise in writing.

By providing my initials above, I acknowledge my understanding and agreement to the foregoing terms.

I agree that any legal proceeding shall be filed solely in the County of Washington, State of New York and I further agree that the substantive law of the State of New York shall apply in that action without regard to the conflict of lawrules of that state. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect. By signing this document, I acknowledge that if anyone is hurt or property is damaged during my participating in this activity, I may be found by a court of law to have waived myright to maintain a lawsuit against Gym on the basis of any claim from which I have released them herein. I have hadsufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms.

I understand and agree that: (I) that this Waiver, Release and Assumption of Risk gives up important legal rights; (ii)I am giving up these important legal rights voluntarily, freely, under no threat of duress, without inducement, promise or guarantee being communicated to me; and (iii) the signature below is proof of my intention to execute acomplete and unconditional WAIVER AND RELEASE of all liability to the full extent of the law.

Date: March 29, 2020

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*
I have read and understand the terms of this WAIVER, RELEASE AND ASSUMPTION OF RISK AGREEMENT and unconditionally agree to its full terms, statements, warranties, notices representations, waivers and releases on behalf of both myself and marital community, if any and my child or ward whose name is:(Print the Child/Minor or Ward’s Name)(Child/Minor or Ward’s Date of Birth) All such terms, statements, warranties, notices, representatives, waivers and releases fully apply to my child/minor/or ward as if I was the participant. I understand that, by signing this Consent, I am giving up important legal rights both on behalf of myself and my child/minor or ward regarding potential rights and claims against Gym. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms. I hereby warrant and represent that if I am neither the Child’s Parent nor legal Guardian, I have been granted the expressed authority to execute this Waiver, Release and Assumption of Risk Agreement by, and on behalf of, theChild’s Parent or Guardian. In the event that I do not have the authority to execute this agreement on behalf of another, I agree that I shall be solely liable for any and all claims, actions, penalties, causes of action, services, feesor similar expense.
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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