First + Last Name
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First Name
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Phone Number
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Address, City, State
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INDULGE Liability Waiver
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RELEASE OF LIABILITY – INDULGE Lifestyle LLC and Sarah Buchanan
By my signature hereto, I HEREBY ASSUME ALL THE RISKS OF PARTICIPATING AND/OR VOLUNTEERING IN THIS ACTIVITY/EVENT, including, but not limited to, any risks that may arise from negligence or carelessness on the part of the persons or entities herein being released, from dangerous or defective equipment or property owned, leased, maintained, or controlled by them, or because of their possible liability without fault.
I certify that I am physically fit, have sufficiently prepared or trained for participation in the activity or event, and have not been advised to not participate by a qualified medical professional.
I certify that I suffer from no health-related reasons or problems, which may preclude my participation in this physical activity or event.
I acknowledge that this General Waiver and Release of Liability Form will be used by the event holders, sponsors, owners, and organizers of the activity or event in which I may participate, and that it will govern my actions and responsibilities at said activity or event.
In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, Trustees, administrators, heirs, next of kin, guardians, conservators, successors and/or assigns as follows:
(A) I HEREBY WAIVE, RELEASE, AND DISCHARGE from any and all liability, including, but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, and/or actions of any kind which may hereafter occur to me including my traveling to and from this event and/or location, the following entities, persons, and/or employees of: IINDULGE Lifestyle LLC and Sarah Buchanan and all of their members, officers, employees, volunteers, representatives, agents, and/or participants thereof;
(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned herein from any and all liabilities or claims made because of or resulting from my participation in this activity or event, whether caused by or resulting from the negligence of release or otherwise. I acknowledge that INDULGE Lifestyle LLC and Sarah Buchanan and their members, officers, employees, volunteers, representatives, agents, and/or participants are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific event or activity on behalf of INDULGE Lifestyle LLC and Sarah Buchanan and their members, officers, employees, volunteers, representatives, agents, and/or participants. I acknowledge that this activity or event may involve a test of a person’s physical and/or mental limits and may carry with it the potential for death, injury – serious or otherwise, and/or property loss. The risks may include, but not be limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, personal trainers, INDULGE Lifestyle LLC and Sarah Buchanan and their members, officers, employees, volunteers, representatives, agents, and/or participants. These risks are not only inherent to participants, but are also present for volunteers.
(C) I HEREBY CONSENT to receive medical treatment, which may be deemed advisable in the event of injury, accident, and/or illness during this activity or event.
(D) I UNDERSTAND that at this event or related activities, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers, and assigns.
THIS GENERAL WAIVER AND RELEASE OF LIABILITY shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A GENERAL RELEASE OF LIABILITY AND A BINDING CONTRACT AND I SIGN IT OF MY OWN FREE WILL AND INTENT.
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DATE Print Participant’s Name, Age, and Signature (if under 18 years old, Parent or Guardian must also sign
PARENT/GUARDIAN WAIVER FOR MINORS (UNDER 18 YEARS OF AGE)
The undersigned parent and/or natural guardian does hereby represent that he/she is, in fact, acting in such capacity, has consented to his/her child or ward’s participation in the activity or event, and has agreed on behalf of the child or ward, to the terms of the general waiver and release of liability as set forth above. The undersigned parent or guardian further agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and/or ward and the parents or legal guardian(s).
Name _________________________________________________ Signature_______________________________________________ Date ___________________________________________________
Liability Waiver
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RELEASE OF LIABILITY – INDULGE Lifestyle LLC and 1901 fitness co op By my signature hereto, I HEREBY ASSUME ALL THE RISKS OF PARTICIPATING AND/OR VOLUNTEERING IN THIS ACTIVITY/EVENT, including, but not limited to, any risks that may arise from negligence or carelessness on the part of the persons or entities herein being released, from dangerous or defective equipment or property owned, leased, maintained, or controlled by them, or because of their possible liability without fault.I certify that I am physically fit, have sufficiently prepared or trained for participation in the activity or event, and have not been advised to not participate by a qualified medical professional.I certify that I suffer from no health-related reasons or problems, which may preclude my participation in this physical activity or event.I acknowledge that this General Waiver and Release of Liability Form will be used by the event holders, sponsors, owners, and organizers of the activity or event in which I may participate, and that it will govern my actions and responsibilities at said activity or event.In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, Trustees, administrators, heirs, next of kin, guardians, conservators, successors and/or assigns as follows:(A) I HEREBY WAIVE, RELEASE, AND DISCHARGE from any and all liability, including, but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, and/or actions of any kind which may hereafter occur to me including my traveling to and from this event and/or location, the following entities, persons, and/or employees of: INDULGE Lifestyle LLC and 1901 fitness co op and all of their members, officers, employees, volunteers, representatives, agents, and/or participants thereof;(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned herein from any and all liabilities or claims made because of or resulting from my participation in this activity or event, whether caused by or resulting from the negligence of release or otherwise. I acknowledge that INDULGE Lifestyle LLC and 1901 fitness co op and their members, officers, employees, volunteers, representatives, agents, and/or participants are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific event or activity on behalf of INDULGE Lifestyle LLC and 1901 fitness co op and their members, officers, employees, volunteers, representatives, agents, and/or participants. I acknowledge that this activity or event may involve a test of a person’s physical and/or mental limits and may carry with it the potential for death, injury – serious or otherwise, and/or property loss. The risks may include, but not be limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, personal trainers, INDULGE Lifestyle LLC and 1901 fitness co op and their members, officers, employees, volunteers, representatives, agents, and/or participants. These risks are not only inherent to participants, but are also present for volunteers.(C) I HEREBY CONSENT to receive medical treatment, which may be deemed advisable in the event of injury, accident, and/or illness during this activity or event.(D) I UNDERSTAND that at this event or related activities, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by the event holders, producers, sponsors, organizers, and assigns.THIS GENERAL WAIVER AND RELEASE OF LIABILITY shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A GENERAL RELEASE OF LIABILITY AND A BINDING CONTRACT AND I SIGN IT OF MY OWN FREE WILL AND INTENT._______________________________________________________________________________________DATE Print Participant’s Name, Age, and Signature (if under 18 years old, Parent or Guardian must also signPARENT/GUARDIAN WAIVER FOR MINORS (UNDER 18 YEARS OF AGE)The undersigned parent and/or natural guardian does hereby represent that he/she is, in fact, acting in such capacity, has consented to his/her child or ward’s participation in the activity or event, and has agreed on behalf of the child or ward, to the terms of the general waiver and release of liability as set forth above. The undersigned parent or guardian further agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim, or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of the minor and/or ward and the parents or legal guardian(s).
Covid 19 Waiver
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Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
READ CAREFULLY BEFORE SIGNING – INITIAL EACH PARAGRAPH
____ INITIALS By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by participation; and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Property may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Karbank’s employees, volunteers, agents, vendors, event performers and instructors, and program participants and their families.
____ INITIALS I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my participation at the Property. On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless Karbank, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Karbank, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation at the Property.
____ INITIALS I represent that I have adequate insurance to cover any injury or illness I may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or illness myself. I further represent that I have no medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume – and bear the costs of – all risks that may be created, directly or indirectly, by any such condition.
____ INITIALS In the event that I file a lawsuit, I agree to do so in the state of Kansas in the Johnson County, Kansas District Court, and I further agree that the substantive law of that state shall apply. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.
____ INITIALS By signing this document, I agree that if I am exposed or infected by COVID-19 during my participation in this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence.
____ INITIALS I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me or that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for the execution of this release is a reasonable bargain. I have read and understood this document and I agree to be bound by its terms.
____ INITIALS If I have signed a separate general waiver of liability connected to my participation at the Property, I agree that the terms of that waiver are wholly incorporated into this document and that the terms of this document are incorporated into the separate general waiver.
____ INITIALS I agree that I will practice safe social distancing and clean hygiene during my participation at the Property.
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. Karbank Holdings LLC, a Delaware limited liability company (“KHLLC”), Karbank Techpark LLP, a Missouri limited liability partnership (“KTLLP”) and Karbank Real Estate Company LLC, a Missouri limited liability company (“KREC” and, together with KHLLC and KTLLP, “Karbank”) have put in place preventative measures to reduce the spread of COVID-19 at the Karbank properties located at The 1900 Building and The Barney Building, respectively located at 1900 and 2000 Shawnee Mission Parkway, Mission Woods, KS 66205 (together with all associated buildings, green spaces, common areas, leased spaces, restrooms, restaurants, parking garages, paved areas, etc. at both locations, the “Property”); however, Karbank cannot guarantee that you will not become infected with COVID-19. Further, participation could increase your risk of contracting COVID-19.
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PARENT OR GUARDIAN ADDITIONAL AGREEMENT (Must be completed for participants under the age of 18)
In consideration of _________________________________ (PRINT minor’s names) being permitted to participate in this activity, I further agree to indemnify and hold harmless Releasees from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor.
Parent or Guardian Print Name Date
Venmo Sarah-Buchanan-16
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$99 for one month OR $185 for two months
Venmo: Sarah-Buchanan-16
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