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Enabling Movement Foundation 
Adaptive Gym Equipment Use
Participant Release & Waiver of Liability


Enabling Movement Foundation’s adaptive gym is designed for the disabled and/or their caregiver to independently self-manage their exercise routine with provided specialized equipment.  By using the equipment (including, but not limited to; overhead lift, partial weight-bearing sling, treadmill, standing frame and other specialized adaptive equipment with Enabling Movement Foundation), I assume all risks and liabilities of the activities and release Enabling Movement Foundation from any claim by me, my representatives, and my heirs or next of kin.

1. I understand the nature of the equipment provided by Enabling Movement Foundation and I am qualified to use such equipment. I understand that the use of equipment may involve operating machinery, handling weights, or using apparatuses in areas where inherent hazards such as mechanical malfunctions, improper use, or accidental injury are to be expected. I further agree that if at any time I believe conditions to be unsafe, I will immediately discontinue further use of the equipment.


2. I fully understand that: (a) The equipment provided by Enabling Movement Foundation involves risks and danger of serious bodily injury, including permanent disability, paralysis, and death. (b) These risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the activity, the actions or inactions of nonparticipants, the conditions in which the activities take place, or the negligence of the participants, organizers and patrons of the Enabling Movement Foundation  (c) There may be other risks and social and economic losses either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for any losses, costs, and damages I may incur as a result of my participation in the activity.


 

3. I RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO HOLD HARMLESS ENABLING MOVEMENT FOUNDATION, THEIR RESPECTIVE ADMINISTRATORS, DIRECTORS, AGENTS AND EMPLOYEES, OTHER PARTICIPANTS, ANY SPONSORS, ADVERTISERS, AND IF APPLICABLE, OWNERS AND LEASERS OF PREMISES ON WHICH THE ACTIVITIES TAKE PLACE, FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THEM, INCLUDING NEGLIGENT RESCUE OPERATIONS.


4. I hereby grant Enabling Movement Foundation the irrevocable right to use and reproduce my name and my photograph (digital or otherwise), video or likeness for promotional purposes, including but not limited to publication on the internet, in press materials, and in advertising and marketing materials. This right is granted from the time Enabling Movement Foundation receives or creates materials featuring my name, photograph, or likeness. I specifically release Enabling Movement Foundation and its agents from any and all claims, of any and every nature, based on any use or uses of the above. I certify that I am over eighteen years of age and am under no legal or contractual disability to grant the rights and license above. If the participant is a minor, then I hereby give my permission on their behalf as their parent or legal guardian.


5. I further understand that the equipment may collect data related to my usage, performance, and other metrics. I consent to the collection, storage, analysis, manipulation, and dissemination of this data for research purposes.



I have read the release and waiver fully and completely. I understand all that I have read, and I desire to be bound by all of its provisions in exchange for the ability to participate in the equipment program. 

Date: March 10, 2026

First Participant's Name
First Name*
Last Name*
First Participant's Date of Birth*
Date of Birth
Information
What city do you live in? *
Denton TX
Flower Mound TX
Highland Village TX
Lewisville TX
Mansfield TX
Other
Does Participant have an Out-Of-Hospital Do-Not-Resuscitate Order? *
No
Yes
If yes, please provide a copy.
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
What city do you live in? *
Denton TX
Flower Mound TX
Highland Village TX
Lewisville TX
Mansfield TX
Other
Does Participant have an Out-Of-Hospital Do-Not-Resuscitate Order? *
No
Yes
If yes, please provide a copy.
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
What city do you live in? *
Denton TX
Flower Mound TX
Highland Village TX
Lewisville TX
Mansfield TX
Other
Does Participant have an Out-Of-Hospital Do-Not-Resuscitate Order? *
No
Yes
If yes, please provide a copy.
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
What city do you live in? *
Denton TX
Flower Mound TX
Highland Village TX
Lewisville TX
Mansfield TX
Other
Does Participant have an Out-Of-Hospital Do-Not-Resuscitate Order? *
No
Yes
If yes, please provide a copy.
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
What city do you live in? *
Denton TX
Flower Mound TX
Highland Village TX
Lewisville TX
Mansfield TX
Other
Does Participant have an Out-Of-Hospital Do-Not-Resuscitate Order? *
No
Yes
If yes, please provide a copy.
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
What city do you live in? *
Denton TX
Flower Mound TX
Highland Village TX
Lewisville TX
Mansfield TX
Other
Does Participant have an Out-Of-Hospital Do-Not-Resuscitate Order? *
No
Yes
If yes, please provide a copy.
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
What city do you live in? *
Denton TX
Flower Mound TX
Highland Village TX
Lewisville TX
Mansfield TX
Other
Does Participant have an Out-Of-Hospital Do-Not-Resuscitate Order? *
No
Yes
If yes, please provide a copy.
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
What city do you live in? *
Denton TX
Flower Mound TX
Highland Village TX
Lewisville TX
Mansfield TX
Other
Does Participant have an Out-Of-Hospital Do-Not-Resuscitate Order? *
No
Yes
If yes, please provide a copy.
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
What city do you live in? *
Denton TX
Flower Mound TX
Highland Village TX
Lewisville TX
Mansfield TX
Other
Does Participant have an Out-Of-Hospital Do-Not-Resuscitate Order? *
No
Yes
If yes, please provide a copy.
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Information
What city do you live in? *
Denton TX
Flower Mound TX
Highland Village TX
Lewisville TX
Mansfield TX
Other
Does Participant have an Out-Of-Hospital Do-Not-Resuscitate Order? *
No
Yes
If yes, please provide a copy.
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact
First Name*
Last 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 or disabled adult with guardian appointed for protection) 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*
Date of Birth
Information
What city do you live in? *
Denton TX
Flower Mound TX
Highland Village TX
Lewisville TX
Mansfield TX
Other
Does Participant have an Out-Of-Hospital Do-Not-Resuscitate Order? *
No
Yes
If yes, please provide a copy.
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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