EMPOWER WELLNESS LLC

(Conducted at Spearfish Martial Arts, LLC)

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT

READ CAREFULLY — THIS AGREEMENT AFFECTS YOUR LEGAL RIGHTS.

By enrolling in or participating in any fitness training, group classes, personal training sessions, conditioning programs, or wellness activities provided by Empower Wellness LLC, whether conducted at Spearfish Martial Arts, LLC or elsewhere, I acknowledge and agree as follows:

1. ASSUMPTION OF RISK

I understand that participation in fitness training and exercise programs involves inherent risks, including but not limited to:

• Muscle strains, sprains, tears, soreness, and fatigue

• Joint injuries (knees, hips, shoulders, back, neck)

• Overexertion, dizziness, fainting, dehydration, heat illness

• Cardiac events, shortness of breath, or other medical complications

• Slips, falls, or contact with equipment or other participants

• Permanent injury, disability, or death

I further understand that participation may involve shared equipment and close proximity to others, which may expose me to communicable illnesses, including but not limited to skin infections such as staph/MRSA, ringworm, fungal infections, and other bacterial or viral conditions.

I acknowledge that these risks may be caused by my own actions or inactions, the actions or inactions of others, the condition of the facility or equipment, or the negligence of the Released Parties.

I certify that I am physically and medically able to participate and have no condition that would make participation unsafe. I agree to immediately stop exercising if I feel pain, dizziness, illness, or unsafe conditions.

I freely and voluntarily assume all risks, known and unknown, associated with participation.

2. RELEASE AND WAIVER OF LIABILITY

I hereby release, waive, discharge, and covenant not to sue:

• Empower Wellness LLC,

• Spearfish Martial Arts, LLC,

• and each of their respective owners, members, managers, officers, directors, administrators, employees, independent contractors, trainers, instructors, coaches, assistants, volunteers, staff, affiliates, and if applicable, owners and lessors of the premises

(collectively, the “Released Parties”)

from any and all liability, claims, demands, actions, or causes of action arising out of or related to my participation in any fitness or training activities.

This release includes claims arising from the ordinary negligence of the Released Parties, to the fullest extent permitted by South Dakota law.

This release does not apply to claims resulting from gross negligence, willful or wanton misconduct, or intentional acts, to the extent such claims cannot be waived under applicable law.

3. INDEMNIFICATION AND HOLD HARMLESS

I agree to indemnify, defend, and hold harmless the Released Parties from and against any and all claims, demands, damages, losses, liabilities, costs, or expenses (including attorney’s fees) arising out of or related to:

1. My participation in Empower Wellness LLC activities, and/or

2. Any claim brought by or on behalf of me despite this Agreement.

4. COMMUNICABLE & SKIN DISEASE ACKNOWLEDGMENT

I acknowledge that fitness training involves shared spaces and equipment. While reasonable cleaning and hygiene practices are used, no facility can eliminate all risk of illness or infection.

I agree that I will not participate if I have a known or suspected contagious condition, including active skin infections, open wounds, fever, or illness, and I will notify Empower Wellness LLC staff if such a condition arises.

I voluntarily accept and assume all risks related to communicable or skin-related conditions.

5. MEDICAL AUTHORIZATION

I authorize Empower Wellness LLC and/or Spearfish Martial Arts, LLC representatives to obtain or administer first aid or emergency medical care if deemed necessary. I understand I am solely responsible for any medical expenses incurred.

6. PHOTO / VIDEO RELEASE

I grant Empower Wellness LLC and Spearfish Martial Arts, LLC permission to use my likeness in photographs and/or videos for marketing, promotional, educational, or lawful purposes, without compensation.

I understand these images become the property of the respective companies and may be edited, published, or distributed without restriction. I waive any right to inspect or approve the finished product or receive royalties.

If I do not wish to be photographed or recorded, I understand it is my responsibility to notify staff in writing.

7. GOVERNING LAW & VENUE (SOUTH DAKOTA)

This Agreement shall be governed by the laws of the State of South Dakota, without regard to conflict-of-law principles.

Any legal action arising out of this Agreement or participation in Empower Wellness LLC activities shall be brought exclusively in state court located in Lawrence County, South Dakota, or, if federal jurisdiction applies, in the United States District Court for the District of South Dakota.

8. SEVERABILITY

If any provision of this Agreement is found unenforceable, the remaining provisions shall remain in full force and effect.

9. PARENTAL CONSENT & INDEMNIFICATION (MINORS ONLY)

I am the parent or legal guardian of the minor participant. I understand the nature of the fitness activities and believe the minor is capable of participating safely.

I hereby release, discharge, and covenant not to sue the Released Parties for any claims arising out of the minor’s participation, to the fullest extent permitted by law.

I further agree to indemnify, defend, and hold harmless the Released Parties from any claims, damages, liabilities, costs, or attorney’s fees arising out of or related to the minor’s participation.

I understand that some jurisdictions limit a parent’s ability to waive a minor’s future claims; however, I expressly waive my own claims and agree to indemnify the Released Parties to the fullest extent permitted by South Dakota law.

Name: {name}
Date Signed: {sign_date}
Electronic Signature: