Waiver of Liability, Release, Assumption of Risk and Indemnification Agreement
(BREATHE TOGETHER YOGA AND WELLNESS STUDIO)
CLIENT INFORMATION:
Name:
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EMERGENCY CONTACT INFORMATION:
Assumption of Risk: I, , understand and acknowledge that Just Breathe, LLC (“Studio”) offers fitness, health and wellness services and activities on and off its premises and entry upon and use of the Studio’s premises, facilities, equipment, and services and participation in the Studio’s activities, including but not limited to various modes physical therapy, physiological therapeutics, nutrition treatment, acupuncture, ayurveda and other alternative medicines, massage, bodywork, pain management, physical movement therapy, yoga, yoga therapeutics, feng shui, reiki, acrobatics, corde lisse (aerial rope), and other fitness, health and wellness activities, retreats, consultation, classes, workshops or events associated therefore, or consumption of food, beverages, or drugs, involve risks to my or third party’s property and person, including but not limited to loss of or damage to personal property, serious or catastrophic personal injuries and death, injury to the head, neck or spine, injury to the muscular or skeletal systems, injury to internal organs, scratches, cuts, burns, bruises, strains, sprains, contusions, loss or damage to sight, teeth or hearing, paralysis, heart attacks, concussions, brain damage, long or short-term disability, mental injury, and exposure to COVID-19. I acknowledge and agree that I am solely responsible for my safe and responsible entry upon and use of the Studio’s premises, facilities, equipment, and services and participation in the Studio’s activities, whether or not supervised by a Studio representative. I understand and agree that the Studio, its affiliated organizations, owners, partners, directors, officers, employees, contractors, agents, assigns and sponsors (collectively “Studio Parties”) is not responsible for the safekeeping of my personal property while I am on and in the Studio’s premises or using the Studio’s facilities, services, and equipment or participating in the Studio’s activities. I am aware that my participation in the activities at the physical location of the Studio could result in exposure to COVID-19. I am aware that, if I am over the age of 65 or have an underlying medical problem (such as asthma, chronic kidney or lung disease, diabetes, hemoglobin disorders, immunocompromised or with significant liver disease, heart conditions, obesity or pregnancy) (collectively, “Risk Factors”), I have an increased risk of contracting serious medical issues or potential death if I am exposed to COVID-19. I hereby expressly assume all risk that I may suffer personal, bodily or mental injury or death, economic loss or damage, damages to or loss of property, as a result of my entry upon and use of the Studio’s premises, facilities, services, and equipment or participation in the Studio’s activities. For clarity purposes, the “Studio Parties” mean “Studio, its affiliated organizations, owners, partners, directors, officers, employees, contractors, agents, assigns and sponsors” as defined above and as used in this Agreement.
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Voluntary: I acknowledge that I am voluntarily entering upon or using the Studio’s premises, facilities, equipment, and services, and participating in the Studio’s activities on or off the Studio’s premises.
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COVID-19: I acknowledge that COVID-19 infections have been confirmed in every state in the United States and throughout the world. In accordance with the guidance and protocols issued by the Centers for Disease Control & Prevention, the State of California Department of Health (collectively, the “Health Authorities”) for slowing the transmission of COVID-19, I hereby agree, represent, and warrant that I shall comply to CDC (Centers for Disease Control & Prevention) and Santa Clara County’s most recent and up-to-date health guidelines. I further agree that I shall not visit or utilize the facilities, services, and programs of the physical location of the Studio if I: (i) experience any symptoms of COVID-19, including, without limitation, fever, cough or shortness of breath, (ii) have a suspected or diagnosed or confirmed case of COVID-19 or (iii) believe that I have been exposed to COVID-19. I agree to notify the Studio immediately if I believe that I have been exposed to COVID-19, have been diagnosed as having COVID-19 or if I experience any of the symptoms of exposure to COVID-19 as described above. The Studio has taken reasonable steps to implement recommended guidance and protocols issued by the Health Authorities as described within its Studio FAQs. I acknowledge that I have read and understood the FAQs and that I will follow all of its protocols. I acknowledge and agree that the Studio may revise its FAQs at any time based on updated recommended guidance and protocols issued by the Health Authorities and best practices. I further agree to comply with the Studio’s revised FAQs prior to utilizing the facilities, services, and programs of the Studio. I acknowledge that there is a risk that I may be exposed to COVID-19 if I participate in any activities at the physical location of the Studio and that such participation may result in exposure to COVID-19, which could result in quarantine requirements, serious illness, disability, and/or death. I acknowledge that the Studio is not responsible if I become exposed to COVID-19 while participating in such activities at the Studio. I therefore assume the full risk and responsibility for any harm that may result if I am exposed to COVID-19 by participating in any such activities at the Studio.
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Waiver: In consideration of being permitted to enter upon the Studio’s premises for whatever reason or to use the Studio’s services, facilities, and equipment and to participate in the Studio’s activities (either online or at the physical facilities) I hereby acknowledge and agree that I, on behalf of myself, my spouse, heirs, next of kin, guardians, distributes, successors, executors, administrators, representatives, or assigns do hereby release and discharge the Studio Parties from any and all claims, causes of actions or liability to me and my spouse, heirs, next of kin, guardians, distributes, successors, executors, administrators, representatives, or assigns for any damages to or loss of property, personal injuries or death I may suffer or sustain while I am in or about the Studio’s premises or resulting from my use of the Studio’s facilities, services, or equipment or participation in the Studio’s activities on or off the Studio’s premises (including online), regardless of whether the same is caused by any act or omission of the Studio Parties, the Studio’s customers, clients, guests, members or my own, negligent or otherwise. I also agree to release and discharge Studio Parties from any act or omission of negligence in rendering or failing to render any type of rescue, emergency, or medical services if I sustain any personal injury while I am on or in the Studio’s premises or while using the Studio’s facilities, services or equipment or participating in the Studio’s activities (either online or at the physical facilities).
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Indemnification and Hold Harmless: I hereby agree to indemnify, defend, and hold harmless the Studio Parties from any and all claims, causes of action or liability for any loss, damage, or injury to property and persons, including death, arising from or relating to my entry upon the Studio’s premises, or use of the Studio’s facilities, services or equipment or direct or indirect participation in the Studio’s activities, including but not limited to, attorneys' fees, expenses, costs and all consequential damages, whether or not resulting from any act, omission or conduct of the Studio Parties.
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Termination: I agree that I shall not engage in inappropriate conduct while in or about the Studio’s premises or using the Studio’s facilities, services or participating in the Studio’s activities . I understand that, in its sole discretion the Studio may terminate my entry upon or use of the Studio’s premises, facilities, services or equipment or participation in its activities at any time even during a session, class, workshop, retreat or a program. Reasons for termination may include, but are not limited to, my failure to comply with the terms of this Agreement or with any rules or regulations adopted by the Studio: inappropriate conduct or other behavior by me deemed detrimental to the best interests of the Studio, its employees, contractors, agents, members, clients, patrons, customers or other participants of the activities; any illicit or sexually suggestive remarks or advances made by me; emergencies; or health or safety considerations. Such termination shall not diminish or otherwise alter any of my dues and other indebtness incurred prior to the date of termination for which I shall remain to be liable. If the Studio terminates my entry upon or use of the Studio’s premises, facilities, services or equipment or participation in its activities during a session, I understand and agree that I will be liable for payment of the scheduled unfinished appointment or retreat.
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Physical Condition: I attest that I am physically capable of using the Studio’s premises, facilities, services and equipment and participating in the Studio’s activities and that I have no known health restrictions or conditions that might jeopardize my safety or health or the safety or health of others during the use of the Studio’s premises, facilities, services and equipment and participation in the Studio’s activities. I understand that some medical conditions may affect the services I may receive from the Studio or my use of the Studio’s facilities, services or equipment or participation in the Studio’s activities, I agree to keep the Studio updated as to any changes in my medical profile. I give permission for the Studio, its contractors, employees or agents to provide immediate and reasonable emergency care should it be required.
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Service and Activities: I understand that all medical conditions cannot be successfully treated by the use of the Studio’s facilities, services, or equipment or the participation of the Studio’s activities. I understand the Studio’s employees, contractors, or agents rendering the Studio’s services and activities are not medical doctors. I further acknowledge and understand that any of the Studio’s services and activities, including but not limited to, massage and bodywork, acupuncture, pain management and other alternative medicine treatments or sessions should not be construed as substitute for medical examination, diagnosis, or treatment and that I should see a physician, chiropractor or other qualified medical specialist for any mental or physical illness or condition.
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Severability: I agree that this waiver of liability, release, assumption of risk and indemnification agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, the invalidity shall not affect other provisions or portions of this Agreement which shall, notwithstanding, continue in full legal force and effect. To this end, the provisions of this Agreement are declared severable.
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Governing Law and Venue. This agreement shall be construed in accordance with, and governed by, the laws of the State of California. The venue for any action arising out of this agreement shall be the County of Santa Clara, State of California. The parties agree to submit to jurisdiction in Santa Clara County, California.
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Privacy and Copyright: I hereby voluntarily, irrevocably, and without any compensation give permission to the Studio to photograph or videotape my actions, likeness, appearance (collectively “Likeness”) while I am participating in the Studio’s classes, workshops, retreats, programs or sessions with a group on or off the Studio’s premises, and reproduce, publish, publicly display, and use my Likeness in any and all media now known or hereafter devised, throughout the universe, in perpetuity for any purpose. I understand and voluntarily accept the possibility of unconsented-to third party use, alteration, or republication; and release the Studio Parties from any and all liability arising out of their publication of my Likeness, or from the unconsented-to use, alteration, or republication of my Likeness by third parties accessing the Internet. I agree not to make any claim against Studio Parties as a result of their photographing, recording, videotaping, reproducing, broadcasting, distributing, publishing, or using of my Likeness including, without limitation, any claim that such use invades any right to privacy or publicity.
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I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS AGREEMENT, UNDERSTOOD IT AND AM AWARE THAT IT CONTAINS A WAIVER OF LIABILITY, RELEASE, ASSUMPTION OF RISK AND INDEMNIFICATION AND THAT I AM GIVING UP SUBSTANTIAL RIGHTS, INCLUDING MY RIGHT TO SUE AND THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE.