Omaha, NE

Farrell's Liability Release

In consideration of Insert Franchise Name, dba Farrell’s eXtreme Bodyshaping (the “School”) accepting the student(s) and providing the instruction designated above, I agree to pay the tuition due in accordance with this Agreement. I understand that the tuition and merchandise package provided for in this agreement represents a discount based on the school’s normal hourly instruction rate and that such tuition will not be reduced as a result of any student’s schedule, attendance or withdrawal from the program. I acknowledge that a $30 fee will be charged for each late payment, dishonored check or electronic funds transfer, and declined credit card debit.

Paid-in-Full agreements: pre-paid tuition and merchandise packages are further discounted in exchange for the student(s) accepting the risk that circumstances beyond their control may prevent their full use of the tuition/merchandise package. Pre-paid tuition is not refundable and non-transferrable. In the event of an illness or injury requiring an absence of 30 days or longer, the term of the agreement may be extended. Prior notice is required to hold/suspend a membership. Notice may be submitted by completing a cancellation form at Insert Location Name with a manager.
I understand that the payable amount may include tuition and materials that may not be returned after use. I understand that I may regularly attend classes only at the locations indicated and may only use the facility during scheduled instruction times during which I must participate in a group fitness class. I agree to comply with the program guidelines and posted rules. As further consideration for the School accepting the Student(s) and providing the instruction designated above, I represent that the Student(s) designated above is (are) a) fully capable of participating in fitness kickboxing and group strength training classes, b) that the health of the student(s) designated above have been evaluated by a qualified physician and c) that the student(s) has (have) not been prohibited from any type of exercise or physical activity.

ASSUMPTION OF RESPONSIBILITY AND RISK
I understand that physical exercise is potentially dangerous. The possibility of injury or aggravation of prior injuries is possible. I understand that all participants have the right and responsibility to excuse themselves from any exercise or activity they believe will be harmful to them. All participants must evaluate each situation in the context of their skill and current physical condition, and conduct each exercise in a manner that is safe. If an instructor gives an instruction that is unsafe for the participant, it is the participant’s responsibility to inform the instructor that the skill may be unsafe.
I understand the above statement of risk, and I understand the rights and responsibilities of participants. I assume responsibility of my own safety (or safety of my child), understanding and accepting the risks involved with group fitness activities and physical fitness testing. By assuming this risk, I completely absolve all instructors, staff, guests, participants, landlords, management companies and any and all other parties of liability for my harm, unless intentionally caused.

I agree to indemnify the school for any liability for injury from the hazards of group fitness and all related activities.

INFORMED CONSENT

I hereby give informed consent to engage in a series of procedures relative to providing relevant information about my health history, taking a series of exercise tests, and participating in a variety of physical activities. I understand the purpose of the testing is to determine my level of physical fitness.

In the event of a medical problem, I recognize that any medical care that may be required is my personal financial responsibility.

I understand that the information collected during testing and on the health history will only be used to evaluate my fitness levels. I give informed consent for my information to be used in an anonymous manner for the purpose of providing sample program result statistics for marketing or research.

CONSENT TO USE PHOTOGRAPHS

IN THE EVENT YOU ARE A PRIZE WINNER, THE FOLLOWING APPLIES: Farrell’s eXtreme Bodyshaping, Inc. periodically conducts contest, and awards prizes to participants based upon such participant’s overall physical improvement, attitude and other factors considered relevant. As a condition to receipt of any such prize, I hereby authorize Farrell’s eXtreme Bodyshaping, Inc, or its affiliates and franchises, to take and use visual/audio images of me, including, but not limited to photographs, digital images, drawings, renderings, sound or video recordings, audio clips or accompanying written descriptions. I agree that Farrell’s eXtreme Bodyshaping, Inc. owns the images and all rights related to them. The images may be used in any manner, media or format (including promotional advertising), without limitation as to frequency or duration, and without notifying me in advance.

ARBITRATION CLAUSE

Should any dispute arise between me, my child, or anyone acting on behalf of my child, regarding this school, then I specifically agree that the dispute shall be resolved in binding arbitration. Should a suit be filed in Court, I specifically authorize the Court to order the case to binding arbitration.

SEVERABILITY AND DURABILITY

If any clause, sentence, phrase or statement is found unenforceable or invalid by any court of law, the remainder of the document shall remain valid enforceable and the invalid clause, sentence, phrase or statement shall be considered struck from the document. This document is effective from the date signed with no expiration. Furthermore, the terms of this document are retroactive to the beginning of training and visiting the school if this document was signed after that date.

Under Iowa law, you have the cancellation rights set forth at the end of this agreement. Notice to Buyer: Do not sign this contract until you read it.

SIGNATURE _____________________________________________ DATE _______________________

CANCELLATION NOTICE

This enrollment may be cancelled within three business days of the transaction date except where enrollment is for a 10 week or other time defined program with limited participant capacity. Enrollment in such programs may be cancelled only prior to the beginning of the course.

To cancel this agreement, notice may be submitted by completing a cancellation form at Enter Location Name Farrell's with a manager.

BUYER’S RIGHT TO CANCEL

Enter date of original transaction: __________________

You may cancel this transaction within three business days from the above date.

If you cancel, any payments made by you under the contract, less twenty dollars, and any negotiable instrument executed by you will be returned within forty-five days following receipt by the seller of your cancellation notice, and any security interest arising out of the transaction will be canceled. After you cancel, the physical exercise club may request the return of all contracts, membership cards, and other documents or evidence of membership.

To exercise your right to cancel within three business days of the original transaction date, complete the cancellation form with a manager at Insert Location Name no later than midnight of ________________. (3 business days following enrollment)

I hereby cancel this transaction _______________.

Buyer’s signature _____________________________________.
 

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