HOLD HARMLESS AND LIABILITY WAIVER
I hereby release and covenant not-to-sue REBELXL and RBX Consulting Inc., its officers and/or owners, their members, staff, volunteers, landlords, agents or assigns from any and all present and future claims resulting from ordinary negligence on the part of REBELXL and RBX Consulting Inc. or any other listed above for property damage, personal injury, or wrongful death, arising as a result of engaging or receiving instruction in Pilates, circuit classes, mat Pilates, workshops or any other activities or any activities incidental thereto, wherever, whenever, or however the same may occur.
Because physical exercise can be strenuous and subject to risk of serious injury, REBELXL and RBX Consulting Inc., urges you to obtain a physical examination from a doctor before using any exercise equipment or participating in any exercise activity. You (each client, guest, and all participating family members) agree that if you engage in any physical exercise or activity, or use any gym amenity on the premises or off premises, including any sponsored gym event, you do so entirely at your own risk. Any recommendation for changes in diet, including the use of food supplements, weight reduction and/or body building enhancement products are entirely your responsibility, and you should consult a physician prior to undergoing any dietary or food supplement changes. You agree that you are voluntarily participating in these activities and use of these facilities and premises and assume all risks of injury, illness, or death. We are also not responsible for any loss of your personal property.
This waiver and release of liability includes, without limitation, all injuries which may occur as a result of: 1) your use of all amenities and equipment in the facility and your participation in any activity, class, program, personal training or instruction;, 2) the sudden and unforeseen malfunctioning of any equipment; 3) our instruction, training, supervision, or dietary recommendations; 4) your slipping and/or falling while in the building, or on the premises, including adjacent sidewalks and parking areas; 5) contact with other participants; 6) the effects of the weather, including high heat and/or humidity; and all other such risks being known and appreciated by me.
I hereby voluntarily waive all claims against REBELXL and RBX Consulting Inc., and/or any others listed above resulting from ordinary negligence, both present and future, that may be made by me, my family, estate, heirs, agents, representatives, or assigns. I understand that fitness classes and activities are related to certain risks, including but not limited to death, serious neck and spinal injuries resulting in complete or partial paralysis, brain damage, and serious injury [to] bones, joints & muscles. Reformers, mats, bikes, and all fitness equipment, and other safety equipment, and apparatus provided for protection, including the active participation of a coach or teacher who will spot or assist in the performance of certain skills, may be inadequate to prevent serious injury. I am voluntarily allowing my child(ren) and/or myself to participate in this activity with knowledge of the risks involved and hereby agree to accept any and all inherent risks of property damage, personal injury, or death. I understand that this waiver is intended to be as broad and inclusive as permitted by the laws of the state of New Jersey and agree that if any portion here is held invalid, the remainder of the waiver will continue in full legal force and effect. I further agree that the venue for any legal proceedings shall be within the state of New Jersey.
“I have read and understand the Waiver and Release of Liability.” ____________________initial
Name:___________________
Signature of named person or guardian:____________________
PHOTO | VIDEO | AUDIO RELEASE FORM
I grant permission to REBELXL and RBX Consulting Inc., and its agents and employees, to use photographs, video images and audio taken of me at any facility or function for use in all marketing, public relations and advertising mediums used by REBELXL and RBX Consulting Inc., and to use such photographs, video images and audio in electronic versions of the same for all media distributions without notifying me.
I hereby waive any right to inspect or approve the finished photographs, video images or audio or printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the photographs, video images and audio.
I hereby agree to release, defend and hold REBELXL and RBX Consulting Inc., and its agents and employees, including any firm publishing and/or distributing the finished product in whole or in part, whether on paper, via electronic media, social media, or on web sites, from and against any claims, damages or liability arising from or related to the use of the photographs, video images or audio, including but not limited to any misuse, distortion, blurring, alteration, optical illusion or use in composite form, either intentionally or otherwise, that may occur or be produced in taking, processing, reduction or production of the finished product, its publication or distribution.
I am 18 years of age or older and I am competent to contract in my own name. I have read this release before signing below, and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to signing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.
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Name (Please Print):
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Signature
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Signature of guardian if under 18 years of age
NON-RECORDING OF LIVE STUDIO/ONLINE CLASSES AGREEMENT
I agree that I will not copy, photograph, broadcast, retransmit or otherwise record in any manner any portion of any Service or any written or other tangible materials used in connection with any Service and that my participation in the Services is solely for my own personal use and not for use by any other person or for any commercial purpose whatsoever. I agree that I will not use any information or knowledge of any kind obtained by me from my participation in the Services for any commercial purpose or pecuniary benefit, whether by me or by others.
I authorize REBELXL and RBX Consulting Inc., to use my image (including photographic, motion picture, and electronic images of me), and my voice (including sound and video recordings) worldwide in any medium whatsoever.
I hereby grant to REBELXL and RBX Consulting Inc., its licensees, successors and assigns, the right to use (whether in live streaming services or otherwise), disseminate, stream, distribute, publish and reproduce, for all purposes, my name and images and pictures of me, including in still photographs, film and electronic form, as well as the sound of my voice, whether in live streaming services or video recordings, and printed and an electronic copy of the information described above in any and all media including, without limitation, the Internet and on the Company’s website, and for exhibition, distribution, promotion, advertising, sales, press conferences, meetings, hearings, educational conferences and in brochures and other media. This permission extends to all languages, media, formats, and markets now known or hereafter devised. This permission shall continue forever and is not limited in geographic scope.
I further grant REBELXL and RBX Consulting Inc., all rights, title, and interest that I may have in all finished images, pictures, negatives, reproductions, videos, and copies of the original print, and further grant the Company the right to give, sell, transfer, and exhibit the images and print in copies or facsimiles thereof, for marketing, communications, advertising, or other purposes, as it deems fit. I recognize that the Company, and not me, has rights and interests in all such materials.
I hereby waive the right to receive any payment for signing this release and waive the right to receive any payment from the Company’s use of any of the material described above. I also waive any right to inspect or approve finished photographs, audio, video, multimedia, or advertising recordings and copy or printed matter or computergenerated scanned images and other electronic media that may be used in conjunction therewith or to approve the eventual use to which it might be applied.
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Name (Please Print)
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Signature
NEW MEMBER QUESTIONNAIRE & FITNESS ASSESSMENT
Date:_________________________________________________
Full Name:____________________________________________
Date of Birth:__________________________________________
Address:
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Tel:___________________________________________________
Email:________________________________________________
Emergency Contact Name:______________________________
Emergency Contact Number:____________________________
Relationship to you:____________________________________
What is your current level of fitness? (not active, moderately active, very active?
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What gym or studios do you currently belong to?
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How many days a week do you currently workout?
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Have you participated in Pilates Reformer for more than 6 months prior to today? If so, where?
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Do you have any fitness goals? If so, what are they?
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Do you have any physical restrictions or limitations? If yes, describe
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Is there any other information the studio should know about your health or fitness in regards to your safety?
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I have read, understood, and completed this questionnaire with truthful answers. Any questions I had were answered to my full satisfaction:
Name:________________________
Signature:_____________________
Date::_________________________
Please Answer Yes or NO
Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
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Do you feel faint in your chest when you do physical activity?
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In the past month, have you had chest pain when you were not doing physical activity?
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Do you lose balance because of dizziness or do you ever lose consciousness?
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Do you have bone or joint problems (for example, back, knee, or hip) that could be worse by a change in your physical activity?
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Is your doctor currently prescribing drugs (for example water pills) for your blood pressure or heart condition?
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Do you know of any other reason why you should not do physical activity?
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I have read, understood, and completed this questionnaire with truthful answers. Any questions I had were answered to my full satisfaction:
Name:________________________
Signature:_____________________
Date::_________________________
CHOICE OF LAW: I understand and agree that the law of the State of New Jersey will apply to this contract.
I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE:
Signature:_____________________
Date::_________________________
Name (printed): :_______________
I am the parent or legal guardian of the minor named above. I have the legal right to consent to and, by signing below, I hereby do consent to the terms and conditions of this Release
Signature:____________________
Date::________________________
Name (printed): :______________