PERSONAL TRAINING INFORMED CONSENT WAIVER AND RELEASE

I, {name}, do hereby consent to participate in a personal training program that will include weight training or cardiovascular exercise. Because physical exercise can be strenuous and subject to the risk of serious injury (including but not limited to musculoskeletal injury, spinal injuries, abnormal blood pressure responses, and rare instances of heart attack or death), it is urged that you obtain a physical examination from a doctor before using any exercise equipment or participating in any exercise activity. You agree that you do so entirely at your own risk by participating in physical exercise or training activities. Any recommendation for changes in diet, including the use of food supplements, weight reduction, or body-building enhancement products, is your responsibility, and you should consult a physician before undergoing any dietary or food supplement changes. You agree to participate in these activities voluntarily, use these facilities and premises, and assume all risks of injury, illness, or death. Rochester Muay Thai is not responsible for any loss of your personal property.
This waiver and release of liability includes, without limitations, all injuries which may occur as a result of;

1. your use of all amenities and equipment at Rochester Muay Thai facility and your participation in any activity, class, program, personal training, supervision, or instruction,
2. the sudden and unforeseen malfunctioning of any equipment
3. our instruction, training, supervision, or dietary recommendations and
4. your slipping and/or falling while in Rochester Muay Thai premises, including adjacent sidewalks and parking areas.

You acknowledge that you have carefully read this “Waiver and Release” and fully understand that it is a release of liability. You expressly agree to release and discharge the trainer/instructor from any and all claims or causes of action, and you agree to voluntarily give up or waive any right that you may otherwise have to bring legal action against Rochester Muay Thai for personal injury or property damage. To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence.

COMMUNICABLE DISEASE WAIVER AND RELEASE

In consideration of being allowed to participate on behalf of Rochester Muay Thai training program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1. Participation includes possible exposure to and illness from infectious diseases, including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of severe illness and death does exist, and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
3. I willingly agree to comply with the stated and customary terms and conditions for participation regarding protection against infectious diseases. If, however, I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
4. I, for myself and on behalf of my heirs, assigns, personal representatives, and next of kin, HEREBY RELEASE AND HOLD HARMLESS Rochester Muay Thai, their officers, officials, agents, employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

MODEL RELEASE

Considering my engagement as a model and for other good and valuable consideration herein acknowledged as received, I hereby grant the following rights and permissions to Rochester Muay Thai and rochestermuaythai.com, its legal representatives, employees, agents, and assigns. They have the irrevocable, perpetual, and unrestricted right and permission to take use, re-use, publish, and republish photographic portraits, pictures, or videos of me or in which I may be included, in whole or in part, or composite or distorted in character or form, without restriction as to changes or alterations, in conjunction with my own or a fictitious name, or reproductions thereof in color or otherwise, made through any medium, and in any and all media now or hereafter known, specifically including but not limited to print media and distribution over the internet for illustration, promotion, art, editorial, advertising, trade, or any other purpose whatsoever. I expressly consent to the digital compositing or distortion of the portraits or pictures, including without restriction any changes or alterations as to color, size, shape, perspective, context, foreground, or background. I also consent to using any published matter in conjunction with such photographs. I hereby waive any right that I may have to inspect or approve the finished product or products and the advertising copy or other matter that may be used in connection with them or the use to which they may be applied.

I understand that the images of me may be used in advertisements and/or website descriptions to promote the business of Rochester Muay Thai. I hereby release, discharge, and agree to hold harmless Rochester Muay Thai and rochestermuaythai.com, its legal representatives, employees, agents, and assigns from any liability by virtue of any blurring, distortion, alteration, optical illusion or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of such photographs or in any subsequent processing of them, as well as any publication of them including without limitation any claims for libel or violation of any right of publicity or privacy.

I hereby warrant that I am of full age and have the right to contract in my own name. I have read the above authorization, release, and agreement prior to its execution, and I am thoroughly familiar with the contents of this document. This document shall bind me and my heirs, legal representatives, and assigns.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

FOR PARTICIPANTS OF MINORITY AGE
(UNDER AGE 18 AT THE TIME OF REGISTRATION)

This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward, including the risks of presence and participation and their responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I, for myself, my spouse, and child/ward, do consent and agree to their release provided above for all the Releasees, and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.

Name: {name} | {dob}  -  Date: {sign_date}
Rochester Muay Thai | 585-317-7925 | rochestermuaythai.com | REV 10– 11/21/23