top of page

NEUROMOTIV

Consent And Release Agreement

READ CAREFULLY BEFORE SIGNING - THIS LIMITS NEUROMOTIV LLC (NEUROMOTIV) LIABILITY

Birthday
Month
Day
Year

SECTION 1

I understand and acknowledge the activities of exercise, movement, Taijiquan, Qigong, Push Hands, Martial Arts, Tactical Training, Gymnastics, Parkour, Ninja Warrior, Climbing, Obstacle Course Training, Health/Performance Assessments, Z-Health, Brain-Based, Corrective Exercise, Fitness Nutrition, Performance Enhancement, Sport Conditioning, Cardiorespiratory Training, Recommendations, BLS, CPR, First Aid, Consultation, Therapeutic Services, Private Lessons, Personal training, Group Training, Online Programs, Clinics, Workshops, Seminars, Events, Services, and Practices collectively know as the activities can be dangerous and involve the risk of injury and death. I understand and acknowledge that these risks include, but are not limited to, loss of control, falling, use of training facilities, equipment, devices, training programs, areas designated as training grounds, and any and all information construed as advice.

SECTION 2

Despite the risks involved in the activities and in consideration of being allowed to participate in the activities, I AGREE TO EXPRESSLY ASSUME ALL RISKS OF INJURY AND DEATH that might be associated with the activities, use of equipment, and facilities utilized through, and/or by NEUROMOTIV, including, but not limited to, the use of equipment,participation in instruction, special events, and participating in the activities beyond the supervised area (collectively referred to as "use of the facilities"). Furthermore, to the fullest extent allowed by law, I AGREE NEVER to SUE AND TO RELEASE FROM LIABILITY NEUROMOTIV, JASON BROWN, LISA BLUE, AND THEIR OWNERS, EMPLOYEES, AGENTS, LANDOWNERS, SPONSORS, AND ALL AFFILITATED COMPANIES, COLLECTIVELY REFFERED TO AS NEUROMOTIV, for any damage, injury, or death to me and or my family members (if applicable) arising from participation in the sport or uses of the facilities, regardless of cause, including the negligence of NEUROMOTIV.

SECTION 3

I UNDERSTAND THIS IS A RELEASE OF LIABILITY THAT IS VALID FOREVER. I understand that this Release of Liability will prevent me or my heirs from filing suit or making any claim for damages in the event of an injury or death to me arising out of participation in the activities or use of the facilities. Additionally, in the event I, my heirs, the user, my legal representative, or any other person acting on my behalf files a lawsuit arising out of my participation in the activities or use of the facilities, I AGREE TO DEFEND, INDEMNIFY AND HOLD HARMLESS NEUROMOTIV for any damages, attornies fees, or costs associated with or arising out of such a lawsuit, with a complete and full understanding of this RELEASE OF LIABILITY AND EXPRESS ASSUMPTION OF RISK AGREEMENT, I nevertheless enter into this agreement freely and voluntarily and agree that it is binding upon me, my heirs, assigns, legal representative and any other person acting on my behalf. I also agree to indemnify NEUROMOTIV for any and all claims brought by a third party which arise from the participant's or my participation in the activities. I grant exclusive permission to NEUROMOTIV to use my name, likeness, video, and photograph, for the purpose of coaching,publicity, public relations, editorial, or other advertising purposes without restriction as to frequency or duration.

SECTION 4

If I am signing this liability release on behalf of a minor (less than 18 years of age): I represent and warrant that I am the parent and or legal guardian of such minor child ("CHILD") and that the CHILD is in good health and there are no special problems associated with the care of the CHILD; I accept responsibility for all the CHILD's medical expenses incurred in connection with the activities or use of the facilities; I agree to indemnify NEUROMOTIV for any and all claims brought by the CHILD or any person acting on CHILD's behalf; * I agree to indemnify NEUROMOTIV for any and all claims brought by a third-party arising in connection with the CHILD's participation in the activity or use of the facilities.

SECTION 5

I understand and agree that this Agreement is severable and that if any clause is found to be invalid, the balance of the contract will remain in effect and enforceable. I agree that any action will be brought in a court of competent jurisdiction in the state of Colorado. Any disputes will be subject to and determined under the laws of the State of Colorado. I HAVE READ THIS DOCUMENT AND UNDERSTAND IT. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARY SURRENDER CERTAIN LEGAL RIGHTS.

Today's Date
Month
Day
Year
Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.
Who is participating?
Adult
Minor
Adult and Minor(s)
Birthday
Month
Day
Year
Birthday
Month
Day
Year
Birthday
Month
Day
Year
bottom of page