Have you ever had or presently have any of these conditions? All "yes" answers must be explained below and discussed with a trainer prior to starting bootcamp.

I, the undersigned, know that participating in the Optimum Fitness Services including without limitation, the Personal Training Fitness Programs, Fitness Classes, Outdoor BootcCamps, TPI Golf Analysis, Nutritional Analysis and Lifestyle Counseling, Lectures, Corporate Weight Loss Competitions and Injury Prevention and Exercise Safety Programs (the "Event") is a potentially hazardous event and I choose to do this out of my own free will and choice. In choosing to do this, I fully accept and assume all risks, whether before, during or after the event and its related events. These include, without limitation, risks of physical injury, mental injury, emotional distress, trauma, death, contact with other participants, equipment failure, inadequate safety equipment, the effects of weather including extreme temperature or conditions, and participating in events before, during, and after the Event. All risks are known and appreciated by me. I waive any and all specific notice of the existence of the risks. I shall assume and pay my medical and emergency expenses in the event of injury, illness, or other incapacity regardless of whether I authorized such expense.

I realize that participating in all aspects of this event that the Event requires physical conditioning and I represent that I am in sound medical condition capable of participating in the Event without risk to myself or others. I have no medical impediment which would endanger myself or others. I understand and agree that a situation may arise during any part of the Event which may be beyond the control of the sponsors, promoters or organizers. I will be solely responsible for the condition and adequacy of my equipment. I will participate safely within the limits of my own abilities and in a manner so as not to endanger either myself or others.

Knowing these facts, I for myself and anyone acting on my behalf release, waive discharge, covenant not to sue and agree to hold Optimum Fitness, Inc., officers, directors, employees, representatives, agents, trainers, insurers, insurance brokers harmless from any and all claims, demands and actions of any and every kind I have, may have or may hereafter accrue against the released parties directly or indirectly arising out of or relating in any respect to my attending or participating in all aspects of this Event. My waiver and release of all claims, demands, actions and liability shall include without limitation, any injury, damage or loss to my person or property which may be (a) caused by any act, or failure to act, by the above identified persons and entities or (b) sustained by me before, during or after being involved in the Event and its related events.

I further agree to indemnify and hold the parties released above harmless from any and all losses, damages, claims and expenses, including attorneys’ fees, arising from or relating in any respect to my participation in the Event or its related events or my breach of this agreement. If I am a minor, my parents or guardian also is signing on my behalf, and we both agree to be bound by the terms of this agreement, waiver and release.

I, the undersigned, hereby grant permission to Optimum Fitness, Inc. to use my likeness, voice, and actions from any video and/or audio tape footage or photographic portraits or pictures captured of me by Optimum Fitness, or personally provided by me to Optimum Fitness.

I agree to forfeit all rights to all video and/audio tape footage or photographic portraits or pictures produced as a result of my work with Optimum Fitness. The footage, portraits or pictures may be used in any manner that Optimum Fitness deems appropriate for marketing and service promotion.

Further, I understand that:

• Optimum Fitness retains sole ownership and copyright of the acquired video footage, and has the exclusive right to edit and incorporate said footage into the master program of the subject media project and/or any such future media projects for which optimum Fitness deems the footage suitable.
• Optimum Fitness will maintain the footage for its media programs only, and will not license or otherwise provide the footage to any other entity outside of Optimum Fitness for any such use.
• Optimum Fitness may use my likeness, voice and actions to advertise and promote business services.
• Optimum Fitness's use of this video or any promotional efforts involving it will not violate the rights of any person or organization. Nor will Optimum Fitness incur any liability for payment to any person or organization.
• Optimum Fintess retains the absolute right and permission to copyright and/or publish the photographic portraits or pictures taken.
• All photographs become the exclusive property of Optimum Fitness, Inc. and I waive all rights hereto.
• I waive all rights to inspect and/or approve copy that may be used in conjunction with the photograph and the use to which it may be applied.
• Any photograph–whole, or in part, or composite–may be used as the publisher sees fit in their publications, any advertising, and for any other lawful purposes.
• In signing this Media Use Talent Release Form, I acknowledge that I have read and understand the agreement and that any questions I may have were answered to my satisfaction, and that I enter into this agreement willingly, and that I shall and herby do release and hold Optimum Fitness harmless from and against any and all loss, cost, damage, injury, liability, or expense or claim therefore, to or with respect to any injury to myself or damage or loss of my property during the course of such participation in the production of this media.

By signing and submitting this form below, I verify that I have answered all of the medical history questions truthfully to my knowledge, I have read and agree with the waiver and release of liability form and have read and agree with the media release form.