Acknowledgement of Risk and Consent Form

I understand that by signing this document I am representing that I understand all of its terms and conditions and that I fully intend to be bound by the same. I also understand that I may wish to consult with my attorney prior to signing this document. In consideration of being allowed to use the Mussel Beach Health Club Inc. (facility), and/or participate in recreational programs or group fitness classes sponsored or offered by the facility, I hereby voluntarily execute this Acknowledgement of Risk and Consent Form. I represent that I am at least eighteen years old and competent to sign this form.

I understand that there are certain dangers, hazards and risks associated with my use of the facility and the equipment located therein (“the equipment”). I further understand that all risks cannot be prevented. In light of the risks associated with the use of the facility and its equipment, I may wish to consult with a physician or other health care provider regarding my current physical and mental fitness prior to beginning any physical fitness workout or regiment. I represent that I am physically and mentally able to use the facility and its equipment in a safe manner.

As a user of the facility, I shall follow all applicable facility policies and procedures and comply with all directives issued by the facility staff. I agree to refrain from the use of offensive or inappropriate language, wear appropriate exercise attire, use the equipment in accordance with its intended use, and respect the individual privacy of others utilizing the facility. I understand that a violation of any facility policies or procedures my result in disciplinary action up to and including suspension or revocation of membership from the facility. I understand and agree that Mussel Beach Health Club, Inc. does not provide medical services or medical personnel at the facility. Therefore I consent to emergency medical care should it be required. I represent that I am covered by adequate medical/health/accident insurance for any injury that I may suffer while using the facility. In the event I must be transported to a doctor or hospital for medical treatment, I acknowledge that Mussel Beach Health Club, Inc. will not be obligated to provide such transportation, nor assume any responsibility for such transportation.

On Behalf of myself, my family, and my heirs, I hereby agree to assume all risks associated with my use of the facility and its equipment, and I hereby release and discharge from liability and waive any legal action against Mussel Beach Health Club Inc., its owners, officers, agents and employees (collectively, “the released parties”) for any personal injury, death, or property damaged I may suffer, due to any cause, including but not limited to the negligence of the released parties, arising out of or in any way connected to my use of the facility and or its equipment.

I understand and agree that this document shall be construed in accordance with the laws of the Commonwealth of Massachusetts. If any term or provision of this document shall be held invalid or unenforceable, the remaining terms and provisions shall remain in full force and effect.