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ACKNOWLEDGMENT, ASSUMPTION OF RISK, RELEASE, WAIVER OF LIABILITY, INDEMNIFICATION, AND HOLD HARMLESS AGREEMENT
THIS IS A LEGALLY BINDING AGREEMENT THAT YOU SHOULD READ CAREFULLY BEFORE SIGNING. BY SIGNING THIS DOCUMENT, YOU ARE WAIVING CERTAIN RIGHTS, INCLUDING THE RIGHT TO BRING A LAWSUIT TO RECOVER DAMAGES IF YOU ARE INJURED WHILE PARTICIPATING IN ANY ACTIVITY AT GENTLEHANDS TALLAHASSEE, LLC. YOU HAVE THE RIGHT TO REFUSE TO SIGN THIS FORM AND RELEASED PARTIES HAVE THE RIGHT TO REFUSE TO LET YOUR CHILD TO PARTICIPATE IF YOU DO NOT SIGN THIS FORM.
DEFINITIONS


GentleHands Tallahassee, LLC, its members, managers, officers, assigns, principals, any associated persons or companies, the physical premises of all business locations as well as all business and service operations performed on behalf of GentleHands Tallahassee, LLC.

ACKNOWLEDGMENT AND ASSUMPTION OF RISK

In consideration of my admission and participation at the GentleHands Tallahassee, LLC, facility, I acknowledge and willingly agree that:
I, and any minor children I am the parent or guardian of, are entering the business or business facility voluntarily and of our own free will.
I, and any minor children I am the parent or guardian of, acknowledge and fully understand that activities within the facility involves risk of injury, including serious and/or permanent physical injuries and death which might result not only from our own actions, inactions or negligence, but also the actions, inactions or negligence of others, including GentleHands Tallahassee, LLC, its members, managers, officers, assigns, principals, agents, employees, class instructors, and volunteers, (hereafter referred to as “Releasees”), the environmental conditions or the equipment used.
I, and any minor children I am the parent or guardian of, are physically able to participate in the activities we voluntarily choose to participate in at the facility and know of no disability or prior injury which would prevent our participation in the activity or potentially lead to our injury or the injury of another.
I, and any minor children I am the parent or guardian of, accept personal responsibility for the damages following such injury, permanent disability or death, including those resulting from the negligence of the Releasees.
I, and any minor children I am the parent or guardian of, knowingly and freely assume all risks, both known and unknown, even those arising from the negligent acts or omission of others and assume full responsibility for our own participation.

RELEASE AND WAIVER OF LIABILITY
I hereby release, waive, discharge and covenant not to sue GentleHands Tallahassee, LLC, its members, managers, officers, servants, agents, employees, class instructors, and volunteers, from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or relating to any loss, damage or injury, including death, that may be sustained by me, or to any property belonging to me, whether caused by the negligence of the Releasees, or otherwise, while participating in any activity at GentleHands Tallahassee.

INDEMNIFICATION AND HOLD HARMLESS AGREEMENT
I further hereby agree to indemnify, save and hold harmless the Releasees, from any loss, liability, damage or costs they may incur due to my participation in any activity, whether caused by the negligence of any or all of the Releasees, or otherwise.
It is my express intent that this agreement shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a Release, Waiver, Discharge and Covenant Not to Sue the above named Releasees.

VIDEO SURVEILLANCE ACKNOWLEDGMENT
I understand that to promote the safety of employees and guests, as well as the security of its facilities, GentleHands Tallahassee, LLC, its licensees or assignees, may conduct video surveillance of any portion of its premises at any time, the only exception being private areas (i.e. restrooms, showers, dressing rooms etc.). Video cameras will be positioned in appropriate places within and around GentleHands Tallahassee buildings, equipment, and facilities and used to promote safety and security of people and property. I understand that this surveillance may occur at any time during my visit to any GentleHands Tallahassee property and hereby give my consent to such video surveillance at any time the company may choose.

PHOTOGRAPH AND MODEL RELEASE ACKNOWLEDGMENT
I understand that GentleHands Tallahassee, LLC, its licensees or assignees, including class instructors, may take photographs, video, or other physical or digitally recorded media on its premises at any time, the only exception being private areas of restrooms, showers, and dressing rooms.
I hereby grant GentleHands Tallahassee, LLC, its licensees or assignees, either separately or together, either wholly or in part, the perpetual and irrevocable and unrestricted right to use my likeness in photographs, video, or other physical or digitally recorded media in any of its publications, including web-based publication, without payment or other consideration. I hereby assign full copyright of these photographs, video, or other physical or digitally recorded media to GentleHands Tallahassee, LLC, its licensees or assignees together with the right of reproduction either wholly or in part.
I hereby grant GentleHands Tallahassee, LLC, its licensees or assignees unrestricted use of these photographs, video, or other physical or digitally recorded media for whatever purpose, including advertising, with any retouching or alteration without restriction. I hereby irrevocably authorize GentleHands Tallahassee, LLC, its licensees or assignees to edit, alter, copy, exhibit, publish, or distribute these photographs, video, or other physical or digitally recorded media for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of any photographs, video, or other physical or digitally recorded media.
I understand and agree that all photographs, video, or other physical or digitally recorded media will become the property of GentleHands Tallahassee, LLC, its licensees or assignees and will not be returned.
I hereby hold harmless, release, and forever discharge GentleHands Tallahassee, LLC, its licensees or assignees 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 have or may have by reason of this authorization.

FAILURE TO ENFORCE IS NOT A WAIVER
We may choose to delay or not enforce any term in this agreement (including fees) without losing our rights. Any failure or delay by us in enforcing strict performance of this agreement (including, but not limited to, accepting late or partial payments or payments marked “payment in full” or tendered with other conditions or limitations) shall not be considered a waiver of any of the terms of this agreement or any of our rights. Any waiver of rights by us must be in writing and signed by one of our authorized representatives.

GOVERNING LAW
This ACKNOWLEDGMENT, ASSUMPTION OF RISK, RELEASE, WAIVER OF LIABILITY, INDEMNIFICATION, AND HOLD HARMLESS AGREEMENT is governed by and shall be construed in accordance with the Laws of the State of Florida. If any provision of this Agreement is deemed unlawful or unenforceable, such provision(s) shall be fully separable, and the remainder of this waiver shall be in full force and effect. The venue of any legal action arising out of, concerning, or involving this agreement, or a claim of any sort against GentleHands Tallahassee, LLC, will be Leon County, Tallahassee, Florida.

In signing this Release, I acknowledge and represent that I have read the foregoing  ACKNOWLEDGMENT, ASSUMPTION OF RISK, RELEASE, WAIVER OF LIABILITY, INDEMNIFICATION, AND HOLD HARMLESS AGREEMENT, fully understand it, and sign it voluntarily as my own free act and deed; that no oral representation, statements or inducements, apart from the foregoing written agreement, have been made; that I am at least eighteen (18) years of age and fully competent; I voluntarily chose to allow myself and the below named minor child(ren) to participate in all activities, equipment, and games present at the facility; that I am the legal parent, guardian or adult caregiver authorized by the legal parent or guardian for the below-named child(ren) and have the permission and authority to agree to the terms within; I have read the facility rules, agree to abide by them and agree that the below named minor childr(ren) will abide by them; I will immediately notify the nearest GentleHands Tallahassee employee or official immediately upon observing any potential hazard; I am responsible for my child(ren)’s safety and behavior at all times; that I execute this Agreement for full, adequate and complete consideration fully intending to be bound by same; and that this Agreement is to be binding upon myself, my heirs, executors, administrators, and representatives in the event of my death or incapacity.
Unless I otherwise notify GentleHands Tallahassee, LLC, this agreement will apply to participant’s future participation in activities by GentleHands Tallahassee, LLC, for ONE YEAR from the date of signature.

By submitting this form, you acknowledge and agree that you are affixing your electronic signature to this document. The parties agree that the electronic signature of a party to this Agreement shall be as valid as an original signature and shall be effective to bind such party to this Agreement.

 

First Participant's Name

First Name*

Last Name*

Phone*
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
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
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.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
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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