Taere Tiai Polynesian Student and Warrior Gym Hold Harmless Agreement: Gym Consent and Waiver Agreement
I request authorization for use of the Gym/Exercise Facilities (Gym) and/or participation in certain optional fitness programs, classes, and activities, including, but not necessarily limited to dance, group fitness, or martial arts classes (Warrior Life Gym) located at 946 Tyler Street, Suite H, Benicia, CA 94510. Taere Tiai Polynesian Dance & Cultural Arts Center uses certain independent contractors (Contractor(s)) to perform the Warrior Life Gym services. I acknowledge that the use of the Gym and participation in the Warrior Life Gym Programs is expressly conditioned on my agreement to each of the terms of this document. I acknowledge and agree as follows:
Assumption of Risk: Use of the Gym and participation in the Warrior Life Gym Programs involve physical exercise, sport and recreational activities that may cause injury. I understand that there is inherent risk of injury when choosing to participate in any physical exercise, sport, wellness, and/or recreational activities. My use of the Gym and participation in the Wellness Programs is a voluntary activity in all respects and I assume all risks of injury and illness that may result from such use and participation. I acknowledge and agree that I am paying no fee (membership, use, or otherwise) for use of the Gym or participation in the Warrior Life Gym Programs.
Health and Fitness Responsibility: I understand that it is my responsibility to consult with a physician prior to and regarding my use of the Gym and participation in the Wellness Programs. I am knowledgeable about the proper use of any equipment that I will use and the rules of any activities that I will participate in and that I will carefully read the operating instructions for any Gym equipment prior to use and will operate such equipment in strict accordance with instructions. I represent and warrant that I am physically fit and I have no medical conditions that would prevent my use of the Gym and full participation in the Wellness Programs. However, I represent and warrant that if a medical condition should arise that would affect my use of the gym or my participation in the Warrior Life Gym Programs, I will let the designated employee(s) or Contractor(s) know, as appropriate.
Confidentiality and Consent: I understand that the information I provide to Taere Tiai Polynesian Dance & Cultural Arts Center and/or Contractor(s) about my health, treatment, care, medical history and/or fitness shall be treated as strictly confidential and will only be disclosed for limited purposes, such as the design or implementation of my Warrior Life Gym Programs and responding to any health or safety issues that may arise during the course of my use of the Gym or my participation in the Wellness Programs.
Compliance and Termination: I agree to follow the instructions of each particular Contractor and any designated employee during the course of my use of the Gym and my participation in the Wellness Programs, and to abide by Taere Tiai Polynesian Dance & Cultural Arts Centers security, safety and office decorum policies and procedures at all times during my participation in the Warrior Life Gym Programs and/or use of the Gym. I understand and agree that my failure to abide by the rules and directives of Taere Tiai Polynesian Dance & Cultural Arts Center or any Contractor(s) while I am using the Gym or participating in any Warrior Life Gym Programs may result in the termination of my participation.
Release of Liability: I do hereby fully release and discharge Taere Tiai Polynesian Dance & Cultural Arts Center and its past and present agents, employees, representatives, officers, directors, attorneys, accountants, trustees, shareholders, investors, subsidiaries, partners, affiliates, members, insurers, heirs, predecessors-in-interest, advisors, successors and assigns, as well as all Contractors (collectively, the “Released Partiesâ€) from any and all liability, claims, and causes of action from injuries or illness (including death), damages or loss which I may have or which may accrue to me on account of participation in all activities utilizing the Gym and/or Warrior Life Gym Programs. This is a complete and irrevocable release and waiver of liability. Specifically, and without limitation, I hereby release the Released Parties from any liability, claim, or cause of action arising out of the Released Parties’ negligence. I covenant not to sue the Released Parties for any alleged liabilities, claims, or causes of action released hereunder. I understand that the Released Parties are not responsible for any loss or theft of personal property brought to or left in the Gym, fitness room and/or studio space and I release Taere Tiai Polynesian Dance & Cultural Arts Center from any liability for such loss or theft.
Emergency Medical Treatment: In the event of an emergency, I authorize Taere Tiai Polynesian Dance & Cultural Arts Center as well as all Contractors, to secure from any licensed hospital, physician, and/or medical personnel any treatment deemed necessary for my immediate care and agree that I will be responsible for payment of any and all medical services rendered.
Gym Policies: I understand and agree to adhere to the Taere Tiai Polynesian Dance & Cultural Arts Center policy and rules, which are available for review in Taere Tiai Polynesian Dance & Cultural Arts Center Student Handbook located in the main lobby.
I have read and fully understand each of the terms, conditions and release of liability set forth above, including the permission to secure medical treatment and the release of all claims, including claims for negligence of the Released Parties. I am 18 years of age or older, or a parent or legal guardian of child that is 12 years and older. I understand that my signed waiver will be retained in my personnel file. This document is binding upon me and my heirs, children, wards, personal representatives and anyone else entitled to act on my behalf.
By clicking below, I acknowledge and agree to the terms of this Taere Tiai Polynesian Dance & Cultural Arts Center Warrior Life Gym Hold Harmless Agreement: Gym Consent and Waiver Agreement.