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Minor Liability Release

Minor

Parent or Guardian

Parent or Guardian Contact Information

1. The minor member and parent or guardian represent that the minor member below is physically capable of participating in exercise and programming provided by Kingsley Group LLC, doing business as Anytime Fitness (herein, "Anytime Fitness") and its owners, members, employees, agents, affiliates, representatives, successors, assigns and instructors. The minor member and parent or guardian understand that physical exercise can be strenuous and subject to risk of serious injury and further understand that no exercise/activity program should be undertaken without the consent of a medical doctor and they are responsible for undertaking to obtain such consent.

2. The minor member and parent or guardian agree that if the minor member engages in any physical activity, or uses any Anytime Fitness amenity, on the premises or off premises, including any sponsored Anytime Fitness event, he or she does so ENTIRELY AT THE RISK OF THE MINOR MEMBER AND PARENT OR GUARDIAN. Any recommendations for changes in diet, including the use of food supplements and/or weight reduction products are entirely the responsibility of the minor member and parent or guardian and they will undertake to consult a physician prior to undergoing any dietary or food supplement changes.

3. The minor member and parent or guardian agree that the minor member is voluntarily participating in the activities provided, directly and indirectly, by Anytime Fitness and the use of facilities and premises provided and ASSUME ALL RISK of injury, illness or death.

4. The minor member and parent or guardian agree that Anytime Fitness is not responsible for any loss of, or damage to personal property.

5. The minor member and parent or guardian understand that the exercises provided by Anytime Fitness may be extremely demanding and take full responsibility for knowing, monitoring and acting within their abilities and learning and incorporating any modifications or adaptations necessary to proceed with such activities in a safe and appropriate manner.

6. The minor member and parent or guardian agree that Anytime Fitness shall not be liable or responsible for any injuries to the minor member which may occur as a result of (a) his or her use of all amenities and equipment provided by Anytime Fitness and his or her participation in any activity, class, program or instruction, (b) the sudden and unforeseen malfunctioning of any equipment, (c) Anytime Fitness instruction, training, supervision or dietary recommendations, and (d) his or her slipping and/or falling while in the facility, or on Anytime Fitness premises, including adjacent sidewalk areas.

7. The minor member and parent or guardian acknowledge that they have read this Waiver & Release and understand that it is a RELEASE OF LIABILITY.

8. The minor member and parent or guardian expressly agree to release and discharge Anytime Fitness from any and all claims, causes of action or judgements that may arise out of any of the events noted in numbers 1 through 7 above and they agree to voluntarily forfeit or waive any right that they may otherwise have to bring legal action against Anytime Fitness for personal injury or property damage. To the extent that statute or case law does not prohibit release for ordinary negligence, this release applies to any ordinary negligence on the part of Anytime Fitness.

9. The minor member and parent or guardian grant Anytime Fitness permission to use the minor likeness in photograph and video in any and all of its publications and in any and all other media, in perpetuity, and for other use by Anytime Fitness. The minor participant and parent or guardian will make no monetary or other claim against Anytime Fitness for the use of such photograph and video.

10. The minor member and parent or guardian understand that payment for all memberships that all sales are final, all payments for products and services are non-refundable, and services are non-transferrable. The minor participant and parent or guardian understand that Anytime Fitness reserves the right to terminate enrollment in any program or membership at any time. If such termination is due, in the sole judgement of Anytime Fitness, to the minor member, disruptive, uncooperative, negligent, reckless or otherwise improper acts or omissions of, or violation of any policy or rule of Anytime Fitness, the minor member and parent or guardian understand that all amounts previously paid will be forfeited.

By signing this waiver and release, I acknowledge that I have read it and understand all of its terms. I agree that I am executing this waiver and release on behalf of myself and on behalf of the minor member. I execute it voluntarily and with full knowledge of its significance. I expressly agree that this release shall be binding upon my heirs, executors, administrators and assigns. I am over 18 years of age and I am the parent or legal guardian of the minor member.

Signature