• 1.  Assumption of Risk – As the parent or guardian of the below named minor or dependant, I assume full responsibility for the decision for my child/dependent to participate in the Lifetime Wellness Challenge.  I acknowledge that participation by my dependent in the activities of Lifetime Wellness Challenge may entail known and unanticipated risks, which could result in physical injury or death.  These risks may also occur as a result of my dependent’s own actions, inactions or negligence.

  • 2.  Release - As part of the consideration for my dependent participating in the activity identified above, I release, discharge, and hold harmless Lifetime Wellness Challenge, any director, officer, employee, or any person acting in any capacity on their behalf from all demands, causes of action, suits contracts, agreements, obligations, covenants, defenses, costs, liabilities and judgments, whatsoever, known or unknown, suspected or unsuspected, in contract or in tort, in law or in equity, which I might have against Lifetime Wellness Challenge, arising from my child/dependent’s participation in the Lifetime Wellness Challenge.

  • 3. Waiver and Indemnification– I hereby waive all claims and demands against Lifetime Wellness Challenge for any loss, damage, injury (including death) or claim of any kind arising from, related to or caused by my dependent’s participation in the Lifetime Wellness Challenge and agree to indemnify, defend, and hold harmless Lifetime Wellness Challenge from all loss, liability, damages, costs, and expenses (including actual attorney’s fees) arising from or related to same.

  • 4. Photography/Video - In permitting my dependent to participate, I understand that my dependent’s photograph/video may appear in publicity or brochures marketing Lifetime Wellness Challenge programs and facilities, if submitted. I understand that there are no rights granted to me or my dependents to inspect or approve photographs/video prior to publication.

  • 5. Term - I have read this Agreement and agree to be bound by its terms. I freely execute this document.

Dated: __________   _______________________________________­­­­­______

                                                              Signature of Parent/Legal Guardian

                                       _____________________________________________

                                                                  Name – Please Print

                                       _____________________________________________

                                                     Name of the Minor/Dependent Participant