By completing this form, you agree to the following:
The undersigned member hereby acknowledges and represents to In-Shape Health Clubs (“In-Shape”) that the above-listed grandparent is authorized to act as the legal guardian of the children listed above at all times while said children are present with the grandparent at the facilities of In-Shape including, but not limited to, for the purpose of checking said children into and out of the In-Shape Kid Zone facility in accordance with In-Shape’s rules and regulations. The undersigned member further acknowledges and represents that the member will notify In-Shape in writing if at any time the grandparent ceases to be authorized by the parent to act as legal guardian of said children.
The undersigned member further agrees as follows:
(1) The use of the facilities of In-Shape, may involve physical exertion, fitness training, exercise, swimming, tennis, basketball, racquetball, weight lifting, aerobic conditioning, cardio training, receiving babysitting care and supervision, and other sporting and recreation activities, including the observation of such activities, all of which involve a risk of serious bodily or physical injury or death, whether caused by the act, failure to act or negligence of In-Shape personnel, members, guests, or other children. I voluntarily accept and assume the risk of such injury for myself and my children listed above.
(2) In-Shape, its employees, officers, directors, shareholders, agents, assigns, representatives, and independent contractors will not be liable to me, my child, our heirs, representatives or estates for any injury sustained by me or my children listed above including, without limitation, personal injury, bodily injury, mental injury or death, occurring while either of us is at the premises of In-Shape, using any of the facilities or equipment thereon, receiving babysitting care and supervision, or participating in any sports, activities, exercises, classes, training, instruction, observation, recreation, or other events of In-Shape, regardless of the cause, including negligence.
(3) FOR MYSELF AND MY CHILD, I HEREBY RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE IN-SHAPE, ITS EMPLOYEES, OFFICERS, DIRECTORS, SHAREHOLDERS, AGENTS, ASSIGNS, REPRESENTATIVES, AND INDEPENDENT CONTRACTORS (hereinafter referred to as “releasees”) from all liability to me or my children, our heirs, representatives, or estates for any loss, damage, or claim therefore on account of injury to me or my children, whether caused by any negligent act or omission of the releasees or otherwise.
(4) I further agree that the foregoing release and waiver of claims is intended to be as broad and inclusive as is permitted by the laws of California and that if any portion hereof is held invalid, I agree that the balance shall continue in full legal force and effect. I acknowledge that I have read this release of claims and waiver of liability and that I am aware of its legal consequences, including that it prevents me, my children and our heirs, representatives and estates from suing or asserting any claims against In-Shape or its employees, officers, directors, shareholders, agents, assigns, representatives, and independent contractors if either of us is injured or damaged for any reason while in, on or about the facilities or premises of In-Shape, receiving babysitting care and supervision, or participating in any activity of In-Shape.
READ THIS DOCUMENT AND UNDERSTAND IT BEFORE SUBMITTING.
THIS IS A RELEASE OF LIABILITY.