RELEASE AND WAIVER OF LIABILITY
1. I, ________________________, hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE World Class Health & Fitness, its owners, agents, employees or designees (collectively "World Class") FROM LIABILITY TO THE UNDERSIGNED, his/her personal representatives, assigns, heirs and next of kin FOR ANY AND ALL CLAIMS, DEMANDS, and/or RIGHTS OF ACTION FOR LOSS OR DAMAGE THAT IS CAUSED BY THE NEGLIGENCE OF WORLD CLASS AND THAT RELATES TO, ARISES OUT OF OR IS IN ANY WAY CONNECTED TO THE UNDERSIGNED'S PARTICIPATION IN WORLD CLASS PROGRAMS AND/OR USE OF WORLD CLASS' FACILITIES OR EQUIPMENT. Participation in World Class programs and use of its facilities or equipment as used above, includes: (a) (b) (c) 3. The supervised and unsupervised use of exercise equipment; Participation in the supervised and unsupervised activities available at World Class in the gym, basketball court and in other individual or group exercise activities; Activities within the use of World Class facilities, such as bathrooms, showers, dressing areas, walk through areas between weights and equipment areas, sidewalks or parking lots.
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I understand that in addition to my participation in activities and use of World Class' facilities or equipment, in certain circumstances, World Class may provide [treatment for minor injuries] and perform emergency treatment, if necessary. I understand that World Class may evaluate my physical fitness, providing instruction and suggestions on matters of physical fitness including exercise, stretching, diet and other lifestyle habits and maintain the premises including equipment. I agree that the RELEASE AND WAIVER OF LIABILITY extends to all acts of negligence by World Class, INCLUDING NEGLIGENT EMERGENCY TREATMENT and is intended to be as broad and inclusive as is permitted by the Laws of the State of Wisconsin. If any portion of this agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect under Wisconsin law. By signing below, I acknowledge that I have had the opportunity to review, discuss and negotiate [ask questions about] the terms and conditions of this agreement. I HAVE READ THIS RELEASE AND WAIVER OF LIABILITY, UNDERSTAND ITS TERMS, UNDERSTAND THAT I WILL BE GIVING UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND I HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTEE BEING MADE TO ME.
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Name: (Please print) Signature: Date: *World Class Health and Fitness Employee: Date:
1055 Cottonwood Ave. Hartland, WI 53029 262-369-8888 Fax 262-369-8876 www.wchf.net 1/31/2008