Health & Medical Information
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XCEL 2 FITNESS INTERNATIONAL CONSENT, WAIVER AND RELEASE AGREEMENT
This is a consent, waiver and release of liability agreement in favor of Xcel 2 Fitness International (“Xcel 2 Fitness”), a North Carolina, nonprofit corporation. I am the parent or legal guardian of the minor set forth below (“Participant”), and I desire that Participant participate in Xcel 2 Fitness’ activities and programs (the “Activities” or, singularly, an “Activity”).
I agree that the Participant is in good health and proper physical condition to participate in physical activities and may participate in the Activities. I understand that during the Activities, the Participant will be involved in physical activities that involve risk and dangers of serious bodily injury caused by Participant’s action or inaction, the action or inaction of others or the negligence of others. I understand that the Participant will consume food and drink provided by Xcel 2 Fitness and third parties and that Participant will receive certain items from Xcel 2 Fitness, including a Pack that contains items in a drawstring bag. I have advised the Xcel 2 Fitness volunteers of any allergies (including foods, drugs, or other allergies) that Participant may have.
Recognizing the risks of the Activities and in consideration for allowing the Participant to participate in the Activities, I for myself and on behalf of Participant and his heirs, successors and assigns freely, voluntarily, and without duress hereby release, forever discharge agree to hold harmless and indemnify (A) each of Xcel 2 Fitness and its owners, directors, officers, contributors, sponsors, employees, contractors, volunteers, representatives, affiliates, franchisees, heirs, agents and successors and assigns; (B) the locations at which the Activities are taking place and such location’s owners, lessors, directors, officers, members, contributors, sponsors, employees, contractors, volunteers, representatives, affiliates, heirs, agents and successors and assigns; (C) the beneficiaries of the Activities and such beneficiaries’ owners, directors, officers, members, contributors, sponsors, employees, contractors, volunteers, representatives, affiliates, heirs, agents and successors and assigns; and (D) any persons participating in a rescue operation or providing first aid, treatment or services in connection with Participant’s participation in an Activity, against and from any and all liability, causes of action, claims, demands of whatever kind or nature (either in law or equity), damages, costs, loss of services, expenses, compensation, all consequential damages and attorneys’ fees (regardless whether pursuant to the laws of any county, state or province) now existing or which hereinafter are claimed by, through or on behalf of me, the Participant or anyone on our behalf related directly or indirectly to the Activities, and specifically including any and all claims for personal injuries, illness, death or property damage sustained while participating in the Activities without regard to the negligence of Xcel 2 Fitness, myself, the Participant or third parties, the condition of the location of the Activity or any other cause.
I hereby authorize Xcel 2 Fitness and its representatives to consent to any and all examinations, anesthetics, x‐rays, dental, medical or surgical diagnoses or treatments, and hospital care, that may be rendered to the Participant before, during or after an Activity. I agree to pay for any such treatment and to reimburse Xcel 2 Fitness for all costs and expenses it may incur in relation to such treatment.
I hereby grant to Xcel 2 Fitness the absolute and irrevocable right and permission, in respect of the photographs and videos that have been or will be taken of the Participant or in which the Participant may be included with others, to copyright the same, in the name of Xcel 2 Fitness or otherwise; to use, re‐use, publish, and republish the same in whole or in part, individually or in conjunction with other photographs and videos, and in conjunction with any printed matter, in any and all media now or hereafter known, and for any purpose whatsoever; and to use my name in connection therewith. I consent to allow the Participant’s name to be released to the press or the public at large prior, during or after an Activity. I hereby release and discharge Xcel 2 Fitness from any and all claims and demands arising out of or in connection with the use of the photographs and videos, including without limitation any and all claims for libel or invasion of privacy.
I hereby warrant and represent that I am 18 years old or older; I have carefully read this agreement, I agree to its terms and conditions and I have signed it freely and without inducement or assurances of any nature; I understand the nature of the Activities; before signing this agreement I had the chance to ask questions; and I am aware that by signing this agreement, I assume all risks and waive and release certain substantial rights that I and Participant may have or possess against Xcel 2 Fitness. To the extent permitted by applicable law, I hereby for myself, my heirs, executors, administrators, assigns or personal representatives knowingly and voluntarily by entering into this agreement irrevocably and unconditionally waive any and all rights, claims or causes of action of any kind whatsoever arising out of the Participant participating in the Activities.
I am the parent or legal guardian of the Participant and this agreement is binding on me, on the Participant and on our respective executors, administrators and heirs. I expressly agree that this agreement is intended to be as broad and inclusive as permitted by the laws of the state of North Carolina, USA. This agreement shall be governed by and interpreted in accordance with the laws of the state of North Carolina, USA. I agree that in the event that any clause or provision of this agreement shall be held to be invalid by any court of competent jurisdiction, the invalidity of such clause or provision shall not otherwise affect the remaining provision of this agreement which shall continue to be enforceable.