RELEASE OF LIABILITY, ACKNOWLEDGEMENT OF RISK,
AND ACCEPTANCE OF RESPONSIBILITY
| Name of Activity or Workshop: | Adaptive Workshops -Leadership Training | Date of Activity or Workshop: |
In consideration of the services of Adaptive Workshops, LLC, their agents, owners, officers, volunteers, participants, employees, and
all other persons or entities acting in any capacity on their behalf (hereinafter collectively referred to as “Adaptive Workshops”), I
hereby l) acknowledge the inherent risks described herein, 2) accept full responsibility for my participation in the above-named
activity or Workshop (“Workshop”), and 3) agree to release, indemnify, and discharge Adaptive Workshops, on behalf of myself, my spouse, my children, my parents, my heirs, successors, assigns, personal representative, and estate, as follows in this Release of
Liability, Acknowledgement of Risk, and Acceptance of Responsibility (“Agreement”):
RISKS OF THE WORKSHOP:
WARNING: There are certain elements of risk involved when participating in the Workshop, including but not limited to, those
caused by use of the electronic equipment, facilities, physical and other conditions of participants, Workshop organizers, and technical
staff.
I HEREBY ASSUME ANY AND ALL OF THE RISKS, KNOWN AND/OR UNKNOWN, OF PARTICIPATING IN THIS
WORKSHOP, including by way of example and not limitation, risks of all activities associated with the Workshop, risks that may
arise from negligence or carelessness on the part of the persons or entities being released, risks from dangerous or defective equipment
or other electronic devices, maintained, rented, or controlled by them, the risk of their possible liability without fault, and/or the risk of
transporting myself and others to and from the Workshop location. I acknowledge that this activity may involve a test of a person’s
physical and mental limits with the intent of improving executive’s training and adaptability. I understand that such risks simply
cannot be eliminated without jeopardizing the essential qualities of the Workshop.
ASSUMPTION OF RISKS AND ACCEPTANCE OF RESPONSIBILITY:
I expressly agree to accept and assume all of the risks existing in the Workshop. My participation in the Workshop is purely voluntary,
and I elect to participate in spite of the risks. I certify that I am eighteen (18) years of age or older, have sufficiently prepared or
trained for participation in the Workshop, have not made any material misrepresentations relating to my physical, mental, or emotional
condition, or other health condition that may be affected by the use of virtual reality technology, and have not been advised to not
participate by a medical professional. I certify that there are no health-related reasons or problems that preclude my participation in the
Workshop.
I acknowledge that this Release of Liability, Acknowledgement of Risk, and Acceptance of Responsibility shall be used by the
Workshop holders, sponsors, and organizers of the Workshop in which I participate and that it shall govern my actions and
responsibilities at said Workshop.
RELEASE OF LIABILITY/WAIVER OF CLAIMS:
I WAIVE, RELEASE, AND DISCHARGE Adaptive Workshops from any and all liability, including but not limited to liability
arising from the negligence or fault of the entities or persons released for my death, disability, personal injury, property damage,
property theft, or actions of any kind which may hereafter occur to me due to my participation in this workshop;
I INDEMNIFY ADAPTIVE WORKSHOPS FOR, HOLD ADAPTIVE WORKSHOPS HARMLESS FROM, AND PROMISE NOT
TO SUE ADAPTIVE WORKSHOPS FOR any and all liabilities or claims made as a result of participation in the Workshop or
transportation to and/or from the Workshop, including any such claims which allege negligent acts or omission or otherwise.
I acknowledge that Adaptive Workshops is NOT responsible for the errors, omissions, acts, or failures to act of any party or entity
conducting a specific activity associated with the Workshop on their behalf.
I hereby consent to receive medical treatment which may be deemed advisable in the Workshop of injury, accident, and/or illness
during this activity.
Should Adaptive Workshops or anyone acting on their behalf be required to incur attorney’s fees and costs to enforce this Agreement,
I agree to indemnify and hold them harmless for all such fees and costs and agree that the prevailing party to any action based on this
Agreement shall be reimbursed by the other for such fees and costs.
I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating in the Workshop, or
else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or
physical condition I may have.
I understand while participating in this activity I may be photographed. I agree to allow my photo, video, or film likeness to be used
for any legitimate purpose by the activity holders, producers, sponsors, organizers, and agents.
The Release of Liability, Acknowledgement of Risk, and Acceptance of Liability shall be construed broadly to provide a release and
waiver to the maximum extent permissible under applicable law.
I CERTIFY THAT I HAVE READ THIS DOCUMENT AGREEMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM
AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT, AND I SIGN IT OF MY OWN FREE WILL
WITHOUT ANY INDUCEMENT OR UNDUE INFLUENCE OF ANOTHER PARTY.
| Participant’s Signature | Date | |
| Participant’s Printed/Typed Name | ||
| Acceptance by Adaptive Workshops | Date |