PERROTTI FITNESS LLC YOUTH FIELD HOCKEY / FITNESS WAIVER & RELEASE OF LIABILITY This form is an important legal document. It explains the potential risk associated with a Field Hockey / exercise program as it relates to your child. It is critical that you read and understand it completely. After you have done so, please print your name legibly and initial in the spaces provided and sign name at the bottom. WAIVER & RELEASE OF LIABILITY I have volunteered myself or child to participate in a program of physical Exercise under the direction of Perrotti fitness LLC which will include, but may not be limited to, Field Hockey, weight (resistance) training, assorted games, movement, flexibility and other assorted exercise skills and drills (i.e. jumping, running, skipping, hopping, throwing, rolling, bouncing, etc) In consideration of Perrotti fitness LLC Training’s agreement to instruct, assist, and train myself or my child. I, on behalf of myself, my heirs, and executors, covenant not to sue Perrotti Fitness LLC, and do here and forever release and discharge and hereby hold harmless Perrotti fitness LLC Training’s respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting there from. ASSUMPTION OF RISK I recognize that exercise might be difficult and strenuous and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of certain unusual physical changes during exercise does exist. These changes include, but are not limited to, abnormal blood pressure, fainting, disorders in heartbeat, heart attack, and in extremely rare instances, death. Although, trainer will take precautions to ensure safety, I expressly assume and accept sole responsibility for my safety and or my Child. I understand that as a result of my participation in an exercise program, my child could suffer any injury or physical disorder that could result in becoming partially or totally disabled and incapable of performing any gainful employment or having a normal social life. I recognize that an examination by a physician should be obtained by all participants prior to involvement in any exercise program. If I have chosen not to obtain a physician's permission prior to beginning this exercise program with Perrotti Fitness LLC, I hereby agree that I am doing so at my/ my child own risk. In all cases, circumstances, situations, events and locations, I acknowledge and agree that I assume the risks associated with any and all activities and/or exercises in which my child participates. I acknowledge and agree that no warranties or representations have been made to me or my child regarding the results I will achieve from this program. I understand that results are individual and may vary. By typing name below, I consent to the use of electronic signature. I understand my typed name has the same legal force as a handwritten signature under the E-SIGN Act. SIGN & DATE