CONSENT AND RELEASE FORM
CONSENT AND RELEASE FORM ADULT PARTICIPATION AGREEMENT
I, the undersigned, in exchange for being given the opportunity to participate in AKYSB AUSTIN WOMEN'S ZUMBA CLINIC (the “Activity”), arranged in whole or in part by His Highness Prince Aga Khan Shia Imami Ismaili Council for the United States of America, its regional and local councils, boards, portfolios, affiliates, members, officers, leaders, employees, staff, volunteers, representatives, and/or agents (the “Institutions”), and all their heirs, executors, successors, representatives, and agents, agree as follows:
I will observe, follow, and comply with all policies, procedures, expectations, rules, regulations, requirements, restrictions, and guidelines set forth for the Activity (the “Rules”), as well as all consequences that result against me due to violation of the Rules, including but not limited to removal from the Activity. I acknowledge that the Institutions have sole discretion to determine all aspects of the Activity, including the Rules and the consequences for their violation, and to take any actions they deem necessary to ensure the safe and proper conduct of the Activity.
I voluntarily and knowingly assume all risks connected with the Activity or my participation in the Activity, including but not limited to the risk of loss, property damage, or personal injury, including death, whether involving, in part or in whole, the conduct (including but not limited to the acts, omissions, negligence, gross negligence, fraud, willful misconduct, or otherwise) of one or more Institutions.
I hereby release and discharge the Institutions from any and all liabilities, losses, claims, demands, suits, actions, causes of action, damages, expenses, and costs (including but not limited to court costs and attorneys’ fees) whatsoever (“Claims”), arising out of or in connection with any loss, harm, or personal injury, including death, that may be sustained by me or another, or any loss of or harm to property belonging to me or another, and in any way connected with the Activity or my participation in the Activity, including but not limited to transportation or lodging, whether involving, in part or in whole, the conduct (including but not limited to the acts, omissions, negligence, gross negligence, fraud, willful misconduct, or otherwise) of one or more Institutions. I also covenant not to pursue against the Institutions any Claims as described in this section.
I hereby agree to indemnify and hold harmless the Institutions for any Claims that they may incur due to my participation in the Activity, whether asserted by one or more Institutions or a third party, whether involving, in part or in whole, the conduct (including but not limited to the acts, omissions, negligence, gross negligence, fraud, willful misconduct, or otherwise) of one or more Institutions.
I hereby consent to any medical treatment which I may need and which arises in connection with the Activity or my participation in the Activity; provided, however, nothing in this agreement shall be deemed an obligation by the Institutions to provide any such medical treatment. I understand that the Institutions do not carry healthcare insurance that covers me, and I am solely responsible for the cost of all medical treatment. I also authorize the Institutions to take any measures necessary in their sole discretion to protect the health of safety of me and others, including but not limited to removing me from the Activity and/or informing my family members, other Institutions, and medical or public health professionals of any actual or suspected concerns in connection with my physical health (e.g., a communicable disease that may spread to others) or mental and emotional health (e.g., behavior that may cause harm to me or others), and any medical or other information related to such concerns.
Except as expressly agreed to in writing by the Institutions, I will bear all costs relating to my participation in the Activity.
I grant to each of the Institutions and each of their representatives, licensees, assigns, and affiliates, the absolute and irrevocable right, permission, consent, and license to take photographs, videos, and sound recordings of me and/or my property during the Activity, and to use, reuse, publish, republish, distribute, and/or modify these photographs, videos, and sound recordings, in whole or in part, individually or in connection with other material, and in any and all media now or hereafter known, and for any legally permissible purpose whatsoever.
This agreement is intended to benefit each of the Institutions, who may enforce the terms of the agreement.
This agreement shall be binding on behalf of my representatives, family members, heirs, successors, assigns, estate, and any other persons or entities claiming through or under me or any of them.
Any controversy or claim arising out of or relating to the Activity and/or this agreement shall, before the filing of a lawsuit or any other legal proceeding, first be submitted for mediation before His Highness Prince Aga Khan Shia Imami Ismaili National Conciliation and Arbitration Board for the United States of America.
The delay or failure of one or more Institutions to exercise any right in connection with this agreement is not to be construed as a waiver of that right.
The provisions of this agreement should be applied to the greatest extent allowed by law. In the event that any provision of this agreement is held invalid or without full legal effect, the remaining provisions shall remain in full force and effect.
I HAVE READ AND VOLUNTARILY SIGN THIS PARTICIPATION AND RELEASE AGREEMENT AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW. I ACKNOWLEDGE THAT I AM AT LEAST 18 YEARS OF AGE AND FULLY COMPETENT.