PIWC Rental Waiver and Release

Waiver & Release of Liability:

In consideration of being allowed to participate in any of the programs, activities, and events that Ugana,
LLC dba Pottstown Integrated Wellness Complex (hereafter referred to as “Facility”) offers, the
undersigned acknowledges, appreciates, and agrees that:

The Participant/Parent for itself or its child understands that all activities of Facility include inherent risks
that cannot be totally eliminated regardless of the care taken by the Facility. The Participant/Parent
acknowledges, understands, and appreciates the types of injuries inherent in the Facility’s activities, and
hereby knowingly assumes all inherent risks of such activities. Furthermore, the Participant/Parent, on
behalf of itself, its spouse, heirs, personal representatives, and assigns (collectively “Releasing Parties”)
does hereby knowingly and voluntarily, fully and forever, waive, release, discharge and covenant not to
sue the Facility for alleged liability from any and all claims arising from the ordinary negligence of the
Facility and any of its current and former principals, directors, officers, employees, agents and
representatives (“Protected Parties”).

This agreement applies to personal injury, including death, from the incidents or illnesses arising from
participation in the Facility’s activities including, but not limited to recreational, practice, or competitive
activity; events; organized or individual training and conditioning activities; tests; classes and instruction;
individual use of facilities, equipment, locker room areas, and all premises, or attendance at such
activities whether or not as a participant, including the associated sidewalks and parking lots, and to any
and all claims resulting from the damage to, loss of, or theft of property (the inclusive activities).
The Participant/Parent also agrees to hold harmless, defend, and indemnify the Facility that is, defend
and pay any costs, including damages awarded, investigation costs, reasonable attorney’s fees, and
related expenses from any and all claims arising from the Participant/Parent’s or its child’s participation in the activities at the Facility. The Participant/Parent further agrees to hold harmless, defend, and
indemnify the Facility against any and all claims of co-participants, rescuers, and others arising from the
conduct of the Participant/Parent or its child in such activities.

The Participant/Parent, certifies that: (i) the Participant/Parent is at least 18 years of age or has reached
the age of majority in the jurisdiction in which it lives or resides and (ii) it is, or its child is, in good physical condition and can participate in sports and related activities, and further agrees and warrants that at any time the Participant/Parent believes conditions to be unsafe, the Participant/Parent will immediately discontinue further participation for itself or its child in the activity.

The Participant/Parent confirms that this waiver supersedes any and all previous oral or written promises
or agreements relating to the subject matter herein. The Participant/Parent understands that this is the
entire agreement between the Facility and itself regarding waiver and acceptance of risk, and cannot be
modified or changed in any way by representations or statements by any agent or employee of the
Facility. The Participant/Parent understands the foregoing assumption of risk, waiver of liability, and
indemnification agreement is intended to be as broad and inclusive as permitted by the laws of the State
of Pennsylvania, and that if any portion thereof is held invalid, it is agreed that the balance shall,
notwithstanding, continue in full legal force and effect, and if legal action is brought, the appropriate trial
court for the County of Montgomery, in the State of Pennsylvania, has the sole and exclusive jurisdiction
and that only the substantive laws of the State of Pennsylvania, shall apply.

The Participant/Parent acknowledges that it has read and understands this agreement. The
Participant/Parent acknowledges and understands that it is giving up substantial rights, including the
rights of its child to sue for damages in the event of death, injury, or loss. The Participant/Parent
acknowledges that it is voluntarily agreeing to these terms, conditions, waivers and releases and intends
this agreement to be a complete release of all liability, including that due to ordinary negligence by the
Protected Parties, to the greatest extent allowed by the laws of the State of Pennsylvania.
Finally, the Participant/Parent takes full responsibility for knowing and abiding by the rules of the Facility
and understands and acknowledges that if it does abide by the rules of the Facility, it risks being banned
from the facility and having all of its money forfeited.

Who will be participating?

Adult  Adult and Children  Children

Parent / Guardian Information

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By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.