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EXAMPLE TERMS FOR RELEASE AND WAIVER OF LIABILITY & ASSUMPTION OF RISK & INDEMNIFICATION AGREEMENT

Participant enters into this Release and Waiver, and Assumption of Risk, for Participant and for any and all of Participant’s guests and Participant’s minor children who Participant permits to use the Remote Programs with or without supervision.

In consideration of being permitted to participate in and use the internet or otherwise offsite or remote services (“Remote Programs”) made available by Providence St. Joseph Health (“Providence”) and offered by Active Wellness LLC, their agents, owners, directors, officers, employees, partners, independent contractors, volunteers, and all other persons acting in any capacity on their behalf (collectively, Active Wellness LLC Parties), I, on behalf of myself, my guests, children, heirs, executors, administrators, successors and assigns, hereby:

Acknowledge, understand and appreciate that my entry upon and/or use of Remote Programs offered by the Active Wellness LLC Parties entails significant risks, both known and unknown, including, without limitation, the possibility of physical or emotional injury), paralysis, death, other serious or catastrophic personal injuries, and loss or damage to personal property.

Expressly agree and promise to accept and assume all of the risks, both known or unknown, that may arise as a result of my entry upon, participation in Remote Programs, of or offered by the Active Wellness LLC Parties, whether such risks are caused or alleged to be caused by the negligent (actively or passively) acts or omissions of any Active Wellness LLC Parties. I hereby confirm that I am voluntarily entering upon, participating in and using the facilities, equipment, services and activities, including Remote Programs, of or offered by Active Wellness LLC Parties, and that I am electing to take such voluntary actions in spite of the risks. I acknowledge and agree that I am solely responsible for my safety and responsible entry upon, participation in, and use of the Remote Programs, of or offered by Active Wellness LLC Parties, whether or not supervised by a Active Wellness LLC Party.

Expressly and voluntarily release and forever discharge Providence and the Active Wellness LLC Parties from any and all claims, demands, causes of action or liability for any loss, damages, injuries or death that I may suffer as a result of my entry upon, participation in or use of the Remote Programs, of or offered by Active Wellness LLC Parties, whether the same arises out of or results from any act, omission or conduct of one or more of Active Wellness LLC Parties, negligent (actively or passively) or otherwise.

Expressly agree to hold harmless, indemnify and defend Providence and the Active Wellness LLC Parties (with attorneys of each Active Wellness LLC Party’s choice) from any and all claims, demands, causes of action, or liability for any loss, damages, injuries or death suffered by any other person in connection with my entry upon, participation in Remote Programs, of or offered by Active Wellness LLC Parties, whether the same arises out of or results from any act, omission or conduct of one of more of Active Wellness LLC Parties, negligent (actively or passively) or otherwise. The agreement by me to hold harmless, indemnify and defend Providence and the Active Wellness LLC Parties is immediate upon the assertion of any claims, demands, causes of action or liability by any other person and is not contingent or dependent upon a finding that my actions caused the loss, damages, injuries or death claimed. The agreement by me to hold harmless, indemnify and defend Providence and Active Wellness LLC Parties includes all consequential damages incurred by Providence and Active Wellness LLC Parties, or which otherwise would be incurred by Providence or Active Wellness LLC Parties absent this agreement, including, but not limited to, all attorney’s fees and costs, court and litigation costs, experts fees and costs, arbitrator fees and costs, mediator fees and costs, payment of any judgment, verdict, award or settlement on behalf of Providence and Active Wellness LLC Parties, and any other damages incurred by Providence or Active Wellness LLC Parties not included in the preceding list which arise as a direct or indirect consequence of the claims, demands, causes of action or liability asserted by any other person.

ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS AGREEMENT AND AM AWARE THAT IT CONTAINS A WAIVER AND RELEASE OF LIABILITY AND THAT I AM GIVING UP SUBSTANTIAL RIGHTS, INCLUDING MY RIGHT TO SUE OR HOLD PROVIDENCE AND THE ACTIVE WELLNESS LLC PARTIES RESPONSIBLE FOR ANY INJURY WHICH I MAY SUFFER. I AM SIGNING THIS AGREEMENT OF MY OWN FREE WILL AND INTEND FOR MY SIGNATURE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Choose Well Fit • 600 California St. 11th FL, San Francisco, CA 94108 • Phone: (415) 741-3300

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