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11/15/2011
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BREAKTHROUGH FITNESS, L.L.C.

WAIVER AND RELEASE OF CLAIMS



By the use of the facilities of Breakthrough Fitness, L.L.C., and execution of this

Agreement the Client expressly agrees that Breakthrough Fitness, L.L.C., its employees

and agents (hereinafter collectively referred to as Breakthrough Fitness, L.L.C.) shall not

be liable for any damages arising from personal injuries sustained by the Client or

his/her guest in, on or about the premises of said facilities or as a result of their using the

facilities and the equipment therein. Client assumes full responsibility for any such

injuries or damages which may occur to Client or guest in, on or about the facilities and

further agrees that Breakthrough Fitness, L.L.C. shall not be liable for any loss or theft of

personal property. Client also specifically agrees that Breakthrough Fitness, L.L.C. shall

not be responsible for such injuries, damages, loss or theft even in the event of

negligence by Breakthrough Fitness, L.L.C., whether such negligence is present at the

signing of this Agreement or takes place in the future. This waiver does not, however,

apply to gross negligence or intentional torts by Breakthrough Fitness, L.L.C.

CLIENT'S INITIALS:____________



I acknowledge that this fitness training is a test of a person’s physical and mental limits

and carries with it the potential for death or serious injury. The risks include, but are not

limited to, those caused by facilities, temperature, weather, condition of client,

equipment, actions of other people including but not limited to employees and agents of

Breakthrough Fitness, L.L.C., and lack of hydration. I hereby assume all of the risks of

participating in this program. I realize that liability may arise from negligence or

carelessness on the part of the persons or entities being released, from dangerous or

defective equipment or property owned, maintained or controlled by them. I certify that I

am physically fit and have not been advised otherwise by a qualified medical person that

I cannot participate. I acknowledge that this Waiver and Release of Claims will be used

by Breakthrough Fitness, L.L.C. and that it will govern my actions and responsibilities in

my training.

CLIENT'S INITIALS:____________



I hereby consent to receive medical treatment, which may be deemed advisable in the

event of injury, accident and/or illness during this fitness training.

CLIENT'S INITIALS:____________



This Waiver and Release of Claims shall be construed broadly to provide a release and

waiver to the maximum extent permissible under applicable law, including its application

to claims brought by my heirs, legal representatives, executors, administrators,

predecessors-in-interest, successors-in-interest, assigns and anyone claiming by, through,

with or under me. I hereby certify that I have read this document and I understand its

contents.

CLIENT'S INITIALS:____________



I HAVE READ AND UNDERSTAND ALL PROVISIONS OF THIS WAIVER

AND RELEASE OF CLAIMS.

_________________________________

Signature



_________________________________

Print Name



_________________________________

Date Line



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