In consideration of being allowed to participate in any way in the program, related events and activities (hereafter called the Program), I undersigned, acknowledge, appreciate, and agree that:
1. The risk of injury from the activities involved in this program significant during all phases of the activity, including the potential for permanent paralysis, disability, and death. These risks include but are not limited to: equipment failure and/or malfunction of my own or other's equipment; my own negligence and/or negligence of others; attack and/or encounter of insects, fatigue, chill and/or dizziness which my diminish my/our reaction time and increase the risk of accident; from dangerous or defective equipment or property owned, maintained, or controlled by Rocknasium DBA Euphoria Davis Pole Studio, abrasions, attempting moves beyond my own skill & capacity.
2. I knowingly and freely assume all such risks, both known and unkown, even if arising from the negligence of the releasees or others, and assume full responsibility for my participation in the program.
3. I willingly agree to comply with terms and conditions for participation. If I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately.
4. I recognize that it may be necessary for the (Releasees) to refuse to terminate my participation if I am judged to be incapable of meeting the rigors or requirements of the Program. I accept the (Releasees) right to take such actions for the safety of myself and/or other participants. I will not engage in any activity beyond my capabilities and will not cause any third part to be endangered by any of my actions during the program. I warrant and represent that I am in good health and have no physical or mental limitations or problems that would affect my safe participation of the safety of others in the program and have not been advised otherwise by a qualified medical person.
5. By participating in or attending any activity in connection with this program, whether on or of the premises, I consent to the use of any photographs, pictures, film or videotape taken of me or provided by me for publicity, promotiom television, websites or any other use, and expressly waise any right or privacy, compensation, copyright or other ownership right connected to same.
6. I, for myself and on behalf of my heirs assigns, personal representatives and next of kin, hereby release, indemnify, and hold harmless Rocknasium DBA Euphoria Davis Pole Studio, and its officers, officials, agents and/or employess, other participants, sponsors, advertisers, and if applicable, owners and lessors or premises used to conduct the program (releasees), from any and all claims, demands, losses, and liability arising out of or related to any injury, disability or death I may suffer, or loss or damage to person or property, whether arising from the negligence of the releasees or otherwise, to the fullest extent permitted by law.
I have read this release of liability and assumption of risk agreement, full undertand that I have given up substantial rights by signing it, and sign it freely and voluntarilty without inducement.
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