SPOONER EVENT WAIVER

I understand that neither Spooner Physical Therapy (“Spooner”), nor anyone employed by Spooner, is liable for any accidents/injuries, and/or other expenses incurred as a result of participation in these programs. I understand that the program(s) that I am participating in can be rigorous, and such physical activity carries inherent risks, including risk of serious physical injury, that cannot be avoided regardless of the care taken to avoid injuries. This waiver of liability includes, without limitation, any and all injuries which may occur as a result of: (1) use of all amenities and equipment in the facility and/or participation in any activity, class, program, personal training or instruction; (2) the malfunctioning of any equipment; and/or (3) instruction, training, supervision or dietary recommendations made by Spooner or anyone employed by the facility.

I understand that I am voluntarily participating in these fitness activities and that my participation is not considered the rendering of professional physical therapy services.

I attest that I am in good health and able to participate in the activities of this program. In addition, I attest that a physical exam has been performed and a physician has provided clearance to perform physical activity.

In the event of an emergency, the Spooner staff will contact appropriate emergency services/personnel at the time of the situation. I understand that in the event of an emergency, every effort will be made to contact the named emergency contact on this form.

Finally, I give permission to Spooner and its agents and employees the irrevocable and unrestricted right to reproduce photographs and/ or video images taken of me, for the purposes of publication, promotion, illustration, advertising or trade, in any manner or medium. I hereby release Spooner and its legal representatives for all claims and liability to said images or video.