Section 1: Accident Waiver, Release of Liability and Indemnity Agreement I, ________________________________________(full name) hereby acknowledge that I voluntarily agree to participate in the With-U, LLC Wellness Challenges and any or all of its components (hereinafter referred to as the “Program”). I am aware that my participation in the Program will be physically demanding possibly leading to possibly serious or fatal injuries. I am participating in the Program fully aware of the risks inherent in my participation and I voluntarily assume the risks of participating in the Program. _______________(Initial Here) I recognize that exercise is not without varying degrees of risk to the musculoskeletal and/or cardio respiratory system. I hereby certify that I know of no medical problems that would increase my risk of illness and injury as a result of participation in a fitness program designed by With-U, LLC. _______________(Initial Here) I understand and have been informed that there exists the possibility of adverse changes during the exercise program. I have been informed that these changes could include abnormal blood pressure, fainting, and disorder of heart rhythm, stroke and very rare instances of heart attack or even death. ________________(Initial Here) As lawful consideration for being permitted to participate in the Program, I, on behalf of my heirs, executors, administrators, legal representatives, guardians, distributees, and assigns, hereby release, waive, discharge, and relinquish With-U, LLC and its agents, officers, principals and employees for any action or causes of action for personal injury, property damage, or wrongful death which may hereafter arise from participation in With-U, LLC fitness training. ________________(Initial Here) I hereby agree to indemnify, save and hold harmless With-U, LLC and its agents, officers, principals and employees from any loss, liability, damage or cost (including attorney fees) which With-U, LLC and its agents, officers, principals and employees which may incur as a result of injury, death, or property damage to the undersigned, or from suit from such personal injury, death, and/or property damage to me. ________________(Initial Here) I understand that once I have signed up for the Wellness Challenge that With-U, LLC cannot process any refunds and if I do not take part or complete my participation I will not receive a refund on any part of my $40 participation fee. This Agreement is intended to be as broad as is permissible under the law of the State of California and this Agreement shall be interpreted under the laws of the State of California. If any portion of this Agreement is invalid and/or is declared to be invalid by a Court of Law, the balance of the Agreement shall continue in full force and effect. Participant Signature__________________________________________________ Print Name_________________________________________________________ Date______________________________________________________________ With-U LLC Representative_________________________________________