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Liability and Consent Waiver

Today’s Date: October 20, 2020

You acknowledge that you will be engaging in certain Activity (as defined below) at Invictus Health and Recovery. Because the Activity can be strenuous and subject you to risk of serious injury or death, Invictus Health and Recovery urges you to obtain a proper physical examination from a licensed medical doctor before beginning any exercise or training program. Further, you will be engaging in the Activity in a confined space close to others which carries with it certain risks of exposure to disease, sickness, and to injury caused by the negligent acts of others. You agree that you are voluntarily participating in the Activity and assume all risks of injury or damage to you or your property from whatever cause, including but not limited to: malfunction of equipment or facilities, negligent acts or omissions of others, and the spread of disease/sickness.

By signing this liability waiver and release, you release and discharge Invictus Health and Recovery, its employees, owners, associated parties, trainer, instructor, coach, doctor, Physical Medicine Associates, CMK Management (collectively the “Invictus Related Parties”) from any and all claims or causes of action for bodily injury, death, disability, paralysis, property damage or theft, or other loss of any kind caused by or arising from the Activity.

For purposes of this release from liability, reference to “Activity” includes, but is not limited to: (a) your use of all amenities and equipment in the Invictus Health and Recovery facility and any off site location and your participation in any activity, class, program, treatment, or instruction; and (b) instruction, training, supervision, or dietary recommendations provided by Invictus Health and Recovery.

You understand that you are not required to participate in the Activity, and if you choose to participate in the Activity, that there are many other opportunities available for you to participate in the same or similar activities elsewhere.

If any part of this liability waiver and release is determined to be unenforceable for any reason or under any circumstance, it is intended that all other terms will be enforced in all other circumstances. You acknowledge that you have carefully read this waiver and release and fully understand that by signing you agree to voluntarily give up any right that you may otherwise have to bring legal action against Invictus Health and Recovery and Invictus Related Parties for negligence, or any other personal injury or property damage or loss action.

Photography/Videography

Events may be videotaped and/or photographed for use in the future marketing materials, including social media. By signing below, you acknowledge that you understand the likely event of professional or amateur photography and videotaping of the event in which you or your child participates, and agree to hold Invictus Health and Recovery or any of its subsidiaries, affiliates, and contracted partners harmless from any claims that would arise out of any internet, email, or any other public display or dissemination of pictures and videos in which you or your child is displayed, portrayed, or pictured. You further acknowledge and understand that you have no ownership rights to such photos/videos/marketing material.

First Athlete's Name

First Name*

Middle Name

Last Name*

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

First Name*

Middle Name

Last Name*
Second Athlete's Date of Birth*
Third Athlete's Name

First Name*

Middle Name

Last Name*
Third Athlete's Date of Birth*
Fourth Athlete's Name

First Name*

Middle Name

Last Name*
Fourth Athlete's Date of Birth*
Fifth Athlete's Name

First Name*

Middle Name

Last Name*
Fifth Athlete's Date of Birth*
Sixth Athlete's Name

First Name*

Middle Name

Last Name*
Sixth Athlete's Date of Birth*
Seventh Athlete's Name

First Name*

Middle Name

Last Name*
Seventh Athlete's Date of Birth*
Eighth Athlete's Name

First Name*

Middle Name

Last Name*
Eighth Athlete's Date of Birth*
Ninth Athlete's Name

First Name*

Middle Name

Last Name*
Ninth Athlete's Date of Birth*
Tenth Athlete's Name

First Name*

Middle Name

Last Name*
Tenth Athlete's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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*

Middle 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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