Youth Evaluation

STANDARD MEDICAL RELEASE

I acknowledge that I, individually, have voluntarily applied to participate in the Parisi Speed School training program. I acknowledge the risks and the potential risks of athletic training. However, I feel that the possible benefits to me and my child are greater than the risk assumed.

I am aware that although The Parisi Speed School Franchise, its subsidiaries, Speed School Franchisor and parent companies, its officers, directors, owners and/or employees make reasonable efforts to make each athlete’s training a safe and productive experience, that there are inherent risks which occur as a result of such physical activity.

I acknowledge that an athlete, when training, through no fault of his own, his trainer(s) or the facility may become injured for a variety reasons that are unavoidable.

I represent that I am in good health and suffer from no physical impairment, which would limit my use of The Parisi Speed School’s facilities or instruction. I further represent that I carry full and complete medical insurance coverage. I acknowledge that the Parisi Speed School has not and will not render any medical services including medical diagnosis of my physical condition.

In consideration of being permitted by The Parisi Speed School to participate its training program and to use its facilities, I hereby, intending to be legally bound for myself, my heirs and assigns, executors or administrators and/or guardian of my son/my daughter/my ward specifically agree that The Parisi Speed School, its officers, employees and agents shall not be liable for any claim, demand, cause of action of any kind whatsoever for, or on account of death, personal injury, property damage or loss of any kind resulting from or related to my use of the facilities or participation in any athletic training, exercise or activity within or outside the club premises, and I agree to hold The Speed Parisi School Franchise harmless from same. I herby waive any and all claims for any and all injuries I may suffer under any circumstances, including but not limited to those claims arising from the negligence of the Parisi Speed School Franchise, Parisi Speed School Franchisor its employees, agents, servants, invitees, co-members, contractors, or sub-contractors, employees or otherwise.

PROMOTIONAL RELEASE

In additional consideration of being permitted by The Parisi Speed School to participate in its training program and to use its facilities, I hereby permit The Parisi Speed School to use my name, image and likeness for promotional purposes limited to its athletic training programs and facilities. The Parisi Speed School’s promotional mediums include but are not limited to print, radio, video, television and the Internet.

I acknowledge that I have read this release and waiver and fully understood its contents. I have been fully and completely advised of the potential dangers incidental to engaging in the activity and instruction of athlete training and I am fully aware of the legal consequences of signing this release. I voluntarily agree to the terms and conditions stated above.

In consideration for receiving permission to participate in any/all services offered by LiveFIT Perrysburg, LLC, I hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE LiveFIT Perrysburg, LLC, its officers, agents, trainers, instructors, volunteers or employees from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or any of the property belonging to me, whether caused by the negligence of any of the above mentioned entities or individuals, or otherwise, while participating in such activities, or while in, on or upon the premises where the activities are being conducted.

It is understood that these activities involve an element of risk and danger of accidents and knowing those risks I hereby assume those risks. I hereby elect to voluntarily participate in said activities with full knowledge that said activities may be hazardous to me and my property. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY, INCLUDING DEATH, which may be sustained by me, or any loss or damage of property owned by me, as a result of being engaged in such activities, WHETHER CAUSED BY THE NEGLIGENCE OF LiveFIT Perrysburg, LLC, its officers, agents, trainers, instructors, volunteers or employees OR OTHERWISE.

I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS LiveFIT Perrysburg, LLC, its officers, agents, trainers, instructors, volunteers or employees from any loss, liability, damage or costs, including court costs and attorney fees, that they may incur due to my participation in said activities, WHETHER CAUSED BY THE NEGLIGENCE OF LiveFIT Perrysburg, LLC, its officers, agents, trainers, instructors, volunteers or employees OR OTHERWISE. I understand that no medical insurance is provided.

It is my express intent that this Waiver of Liability and Hold Harmless Agreement shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE LiveFIT Perrysburg, LLC, its officers, agents, trainers, instructors, volunteers or employees.

IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Waiver of Liability and Hold Harmless Agreement, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am fully competent; and I execute this Release for full, adequate and complete consideration fully intending to be bound by same.