Medical Waiver & Liability Release Form
RELEASE OF LIABILITY
READ CAREFULLY - THIS AFFECTS YOUR LEGAL RIGHTS
In exchange for participation in the activity of independent training, exercising, stretching, participating in a
group exercise class, receiving services such as massage, physical therapy, personal training, nutrition
consultation, and any and all other services organized by Dynamic Natural Advantage Wellness, of 860
HARTFORD AVE, WHITE RIVER JUNCTION, Vermont, 05001 and/or use of the property, facilities and
services of Dynamic Natural Advantage Wellness, I, _________________, of _________________,
_________________, _________________ _________________, agree for myself and (if applicable) for
the members of my family, to the following:
1. AGREEMENT TO FOLLOW DIRECTIONS. I agree to observe and obey all posted rules and
warnings, and further agree to follow any oral instructions or directions given by Dynamic Natural
Advantage Wellness, or the employees, representatives or agents of Dynamic Natural Advantage Wellness.
2. ASSUMPTION OF THE RISKS AND RELEASE. I recognize that there are certain inherent risks
associated with the above described activity and I assume full responsibility for personal injury to myself
and (if applicable) my family members, and further release and discharge Dynamic Natural Advantage
Wellness for injury, loss or damage arising out of my or my family's use of or presence upon the facilities of Dynamic Natural Advantage Wellness, whether caused by the fault of myself, my family, Dynamic Natural
Advantage Wellness or other third parties.
3. INDEMNIFICATION. I agree to indemnify and defend Dynamic Natural Advantage Wellness against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other
litigation costs, which may in any way arise from my or my family's use of or presence upon the facilities of Dynamic Natural Advantage Wellness.
4. FEES. I agree to pay for all damages to the facilities of Dynamic Natural Advantage Wellness caused by any negligent, reckless, or willful actions by me or my family.
5. APPLICABLE LAW. Any legal or equitable claim that may arise from participation in the above shall be resolved under Vermont law.
6. NO DURESS. I agree and acknowledge that I am under no pressure or duress to sign this Agreement and that I have been given a reasonable opportunity to review it before signing. I further agree and acknowledge
that I am free to have my own legal counsel review this Agreement if I so desire. I further agree and
acknowledge that Dynamic Natural Advantage Wellness has offered to refund any fees I have paid to use its facilities if I choose not to sign this Agreement.
7. ARM'S LENGTH AGREEMENT. This Agreement and each of its terms are the product of an arm's length negotiation between the Parties. In the event any ambiguity is found to exist in the interpretation of this Agreement, or any of its provisions, the Parties, and each of them, explicitly reject the application of any
legal or equitable rule of interpretation which would lead to a construction either "for" or "against" a
particular party based upon their status as the drafter of a specific term, language, or provision giving rise to
8. ENFORCEABILITY. The invalidity or unenforceability of any provision of this Agreement, whether
standing alone or as applied to a particular occurrence or circumstance, shall not affect the validity or
enforceability of any other provision of this Agreement or of any other applications of such provision, as the
case may be, and such invalid or unenforceable provision shall be deemed not to be a part of this Agreement.