PARTICIPANT WAIVER AND RELEASE OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
Specific Event Waiver Form for Minors (Under Age 18)
For and in consideration of Sand & Steel, LLC. (“SSF”) allowing the minor identified below to participate in the SSF sanctioned event described above (the “Event” or “Events”); I, for myself, and on behalf of Minor, and the Minor’s parents/legal guardians, heirs and next of kin, and any legal and personal representatives, executors, administrators, successors and assigns, hereby agree to and make the following contractual representations pursuant to this Waiver and Release of Liability, Assumption of Risk and Indemnity Agreement (the “Agreement”);
I hereby represent that (i) I am the parent or legal guardian of the Minor; (ii) the Minor is in good health and in proper physical condition to participate in the Event; and (iii) the Minor is not under the influence of alcohol or any illicit or prescription drugs which would in any way impair the Minor’s ability to safely participate in the Event. I agree that it is my sole responsibility to determine whether the Minor is sufficiently fit and healthy enough to participate in the Event, that I am responsible for the Minor’s safety and well being at all times and under all circumstances while at the Event site.
I understand and acknowledge the risks and dangers associated with the Minor’s participation in TRAINING AND/OR EVENTS as defined below. I understand that the minor could suffer INJURIES as defined below.
I understand that it is my sole responsibility to maintain a safe environment for the minor during the EVENT. I understand that I must remain in attendance at the EVENT for the entire duration that the minor is present. I will ensure that the minor follows directions of SSF staff. I will ensure that the Minor’s actions or inactions do not create an unsafe EVENT environment for myself or others.
I Represent and Warrant that:
1. I have disclosed all present and past injuries of the minor to Sand & Steel Fitness.
2. I have been informed that the minor may be unable to work or attend school because of an INJURY sustained at Sand & Steel or Sand & Steel Event.
3. I have been informed that the minor may be unable to engage in a favorite family or recreational activity because of an INJURY sustained at Sand & Steel or Sand & Steel Event.
4. I have been informed that these INJURIES may occur in locations outside the gym.
5. I have been given an opportunity to ask questions about TRAINING at Sand & Steel Fitness and/or attend a Sand & Steel Fitness EVENT.
6. I further understand that there are also other remote health risks, not listed below. Despite that risk, I still desire to TRAIN at Sand & Steel Fitness and/or attend the EVENT.
7. I have been independently evaluated by a licensed physician, and that licensed physician has determined that I am physically and emotionally capable of participating in the TRAINING and/or EVENT.
8. I have read this document in its entirety or that it has been read to me if I have been unable to read same.
9. I have been made aware that there is a risk for serious or even fatal INJURY, but knowing those risks, it is my desire to allow the minor to TRAIN at Sand & Steel, and/or attend an EVENT.
10. The minor has no symptoms relating to COVID-19 and I have not been exposed to anyone having COVID-19 symptoms in the past 14 days.
REFUSAL TO PROVIDE SERVICES
I understand that Sand and Steel Fitness may refuse to provide TRAINING or permit attendance at an EVENT, if Sand & Steel determines in its sole discretion that the TRAINING or EVENT is unsafe for me to attend, or that my participation in the EVENT potentially creates a safety risk to myself, other Sand & Steel employees, contractors, or TRAINING / EVENT participants. If Sand & Steel makes such a determination, Sand & Steel will refund the unused value of the TRAINING or EVENT.
POTENTIAL RISKS OF INJURY OR DEATH
I understand that:
• there are inherent and unavoidable risks associated with traveling, carpooling, and/or driving to an EVENT;
• as a consequence of these risks and other risks associated with the EVENTS that may not be listed here, I may be seriously ill, hurt, disabled or may die from the resulting injuries, and/or my property may also be damaged;
• hospital facilities, qualified medical care, and emergency medical evacuation may be delayed, limited or unavailable during portions of the EVENTS;
• Sand & Steel assumes no responsibility for providing medical care during the EVENTS, no duty to rescue or assist, and I will have to pay for any medical care and/or evacuation that I incur; and
Despite the above risks, I agree to the below ASSUMPTION OF THE RISKS, RELEASE OF LIABILITY, INDEMNIFICATION Clauses.
ASSUMPTION OF THE RISKS: On behalf of the Minor, I hereby freely assume the inherent risks as well as any other risks not listed that are part of these TRAINING or EVENTS and any harm, injury, illness, or loss that may occur to me or my property as a result of my participation in the TRAINING or EVENTS or during any transportation to or from the EVENTS—including any injury, illness, or loss caused by the negligence of SAND & STEEL FITNESS its employees, agents and officers, its contractors, and other TRAINING or EVENTS participants. I also understand that any equipment that I provide or may borrow or rent from SAND & STEEL FITNESS or any other provider will be used at the Minor’s own risk and that any such equipment is provided without any warranty about its condition or suitability.
COVID-19 ASSUMPTION OF RISK: Please understand that despite all the precautions that you, other members, and/or Sand and Steel may take, we cannot guarantee the Minor’s health or safety, and the Minor may still be exposed to COVID-19, including through interactions with other individuals who have COVID-19. By executing this release and gaining access to the facility, you, on behalf of yourself, your heirs, beneficiaries, representatives, successors and assigns: (1) voluntarily assume all risks associated with any exposure to COVID-19, including, but not limited to suffering any type of medical condition, illness and, potentially, death; and (2) knowingly and voluntarily waive, release, covenant not to sue, forever discharge, indemnify, and hold harmless Sand and Steel Fitness, its parents and subsidiaries and their respective officers, directors, employees, contractors, agents, representatives, successors and assigns (“Released Parties”) from any and all liability, damages, losses, suits, demands, causes of action to the fullest extent permitted by the laws of this state, or any other claims of any nature whatsoever, arising out of or relating in any way to the Minor’s use of the facility and the Minor’s potential exposure to COVID-19.
RELEASE OF LIABILITY: I hereby RELEASE Sand & Steel Fitness, its employees, agents, officers, and contractors, the providers of any equipment used in the EVENTS, landowners, municipal or governmental providers of use permits, and their respective employees, officers, and directors (“the Released Parties”) FROM ALL LIABILITIES, CAUSES OF ACTION, CLAIMS AND DEMANDS that arise in any way from any injury, illness, death, loss or harm that occur to the Minor or to any other person or to any property during the TRAINING or EVENTS or in any way related to the TRAINING or EVENTS, including during transportation to or from the TRAINING or EVENTS. This RELEASE OF LIABILITY includes claims for the negligence of the Released Parties and claims for strict liability for abnormally dangerous activities. This RELEASE OF LIABILITY does not extend to claims that Virginia law does not permit to be released by Agreement. I also agree NOT TO SUE or make a claim against the Released Parties for death, injuries, loss or harm that occur during the TRAINING or EVENTS or are related in any way to the TRAINING or EVENTS.
INDEMNIFICATION HOLD HARMLESS AND DEFENSE: I promise to INDEMNIFY, HOLD HARMLESS AND DEFEND the Released Parties against any and all claims to which Section 3 of this Agreement applies, including claims for their own negligence. I also promise to INDEMNIFY, HOLD HARMLESS AND DEFEND the Released Parties against any and all claims for my own negligence, and any other claim arising from my conduct during the TRAINING or EVENTS. In accordance with these promises, I will reimburse the Released Parties for any damages, reasonable settlements and defense costs, including attorney’s fees, that they incur because of any such claims made against them. I agree that in the event of my death or disability, the terms of this Agreement, including the indemnification obligation in this Section, will be binding on my estate, and my personal representative, executor, administrator or guardian will be obligated to respect and enforce them.
AGREEMENT TO FOLLOW DIRECTIONS: I agree to direct the Minor to follow the rules for the TRAINING or EVENTS provided to me and to follow directions given to me by the leaders of the TRAINING or EVENTS.
INDEPENDENT CONTRACTORS: I acknowledge that SAND & STEEL FITNESS has no control over and assumes no responsibility for the actions of any independent contractors providing any services for the TRAINING or EVENTS.
USE OF MY LIKENESS: I understand that during the TRAINING or EVENTS that the Minor may be photographed or videotaped. To the fullest extent allowed by law, I waive all rights of publicity or privacy or pre-approval that I have for any such likeness of the Minor or use of my name in connection with such likeness, and I grant to Sand and Steel Fitness and its assigns permission to copyright, use, and publish (including by electronic means) such likeness of the Minor, whether in whole or part, in any form, without restrictions, and for any purpose.
PHYSIOLOGICAL EXPERIENCE: I have been informed that during TRAINING or EVENT the Minor may complete physical activities that elicit physiological responses/symptoms that include but are not limited to: elevated heart rate, elevated blood pressure, sweating, fatigue, increased respiration, muscle soreness, cramping, and nausea.
SEVERABILITY: I agree that the purpose of this Agreement is that it shall be an enforceable RELEASE OF LIABILITY AND INDEMNITY as broad and inclusive as is permitted by Virginia law. I agree that if any portion or provision of this Agreement is found to be invalid or unenforceable, then the remainder will continue in full force and effect. I also agree that any invalid provision will be modified or partially enforced to the maximum extent permitted by law to carry out the purpose of the Agreement.
APPLICABLE LAW AND FORUM: This Agreement shall be construed in accordance with the laws of the state of Virginia, without any reference to its choice of law rules. I agree that any dispute arising from this Agreement or in any way associated with the Activities shall be brought only in the Alexandria City Court in Alexandria Country Virginia, or in the Eastern District Court of Virginia, and I agree to the jurisdiction and venue of those courts for any such dispute.
I HAVE FULLY INFORMED MYSELF OF THE CONTENTS OF THIS AGREEMENT BY READING IT BEFORE SIGNING IT. NO ORAL REPRESENTATIONS, STATEMENTS, OR OTHER INDUCEMENTS TO SIGN THIS RELEASE HAVE BEEN MADE APART FROM WHAT IS CONTAINED IN THIS DOCUMENT. I UNDERSTAND THIS IS A CONTRACT THAT AFFECTS MY LEGAL RIGHTS AND I SIGN IT OF MY OWN FREE WILL.
I have been provided with a copy of this agreement, and I consent to the use of an electronic signature.
