WATT PLAZA MONTH-TO-MONTH MEMBERSHIP AGREEMENT

1. LET’S GET STARTED–MEMBERSHIP INFORMATION

Enrollment Date:	Club: Watt Plaza
Name (last, first): ,	Gender:	Date of Birth:
Home Address:
City:	State:	Zip:
Phone:	Email:
* Emergency Contact (full name):
* Emergency Contact Phone:
* Badge ID:

* MEMBERSHIP PLAN

* Recurring Monthly Dues Rate (including taxes):	$45.00/mo
* Membership Start Date:
* Monthly Recurring Billing Date:	Renews once a month on same day as the start date If the day of your billing date does not occur in every month (for example, the 31st), you will be billed on the last day of that month instead.
* First Month Promo:	$10.00 off first month (month-to-month billing resumes at $45.00/mo)
* Registration Fee:	Presale: $0.00

* 2. ELECTRONIC FUNDS TRANSFER (EFT) ACCOUNT

*** I authorize Watt Plaza to charge my payment method.** Watt Plaza is hereby authorized to charge the provided payment method on a monthly basis for monthly membership fees, as well as for any additional purchases made in person at the facility, and for the initial one-time enrollment fees for both primary and add-on members. This authorization encompasses recurring charges for the duration of the membership and grants Watt Plaza the authority to initiate charges for any associated fees or purchases. You may cancel your membership at any time. To cancel, complete a membership resignation form at https://www.waiverking.com/print/56457 or in club at the Service Desk.
*** I agree to the recurring membership charges.** By checking this box, I understand that my membership (including any add-on members) will be billed on a recurring basis starting today, as outlined in the summary above.
Credit/Debit Card	* Account/Card # (last 4 digits from previous screen):	* Exp. Date: /
* Account Holder Signature: Clear (draw your signature)

1875 / 1925 Century Park East • Los Angeles, CA 90067 • phone 310.789.2179

This is a month-to-month agreement and may be terminated as set forth herein.
The Member (or Parent/Guardian, if Member is under 18) agrees to the membership plan indicated above, and is responsible for payment of all associated dues and charges. This agreement is to remain in effect until Active Wellness LLC (the “Operator”) or Watt Properties, Inc., doing business as Watt Plaza (“Watt Plaza”), the owner of the property with a Fitness Center managed by Operator, has received written notice from Member of its termination as indicated in Article III, Section 4 of this document, and the notice has become effective. Operator and Watt Plaza are collectively referred to as the “Fitness Center Parties”. I have read the terms of this agreement on pages 1 through 10 of this document and agree to abide by these terms.
Initial 10-Day Cancellation Policy: You, the buyer, may cancel this agreement at any time prior to midnight of the tenth calendar day after the date you signed this agreement. To cancel this agreement, mail or deliver a signed and dated notice, via certified mail, which states that you, the buyer, are canceling this agreement, or words of similar effect. The notice shall be sent to the address listed below, attn: Member Accounts.

Watt Plaza
1875 / 1925 Century Park East
Los Angeles, CA 90067

This Membership Agreement (this “Agreement”) is between Operator and the applicant for membership identified on page 1 of this Agreement (“Member”)

ARTICLE I. GENERAL POLICIES

SECTION 1. Eligibility for Membership. This is a tenant-only and staff-only fitness center. All Members must be and must remain tenants or staff of Watt Plaza (i.e., the office buildings located at “1875 / 1925 Century Park East, Los Angeles, CA 90067”). Tenancy is subject to ongoing periodic verification. All membership agreements must be on forms prescribed by the Operator of the Fitness Center’ and are subject to approval by authorized personnel and payment of the required fees. Persons 18 years or older may become members.

SECTION 2. Third Party Beneficiary Rights. Member agrees that the Fitness Center Parties are intended beneficiaries of Article II, Article III Section 1, and Article IV Section 3 of this Agreement.

SECTION 3. Transfer of Agreement. Operator. In the event that the agreement with Operator is terminated for any reason, Operator may transfer any or all information (including your personally identifiable information) along with its obligations under this agreement, to the new operator of the Fitness Center.

SECTION 4. Annual Maintenance Fee. In addition to your monthly dues, an annual fee up to $25 may be charged to your account for purposes reasonably required to maintain the Fitness Center. Written notice will be given prior to assessing this fee.

SECTION 5. Data Privacy. Member acknowledges and agrees to the Privacy Policy located at https://www.activewellness.com/privacy

SECTION 6. Amendment of Rules and Regulations. The Fitness Center may from time to time adopt rules, regulations or policies amending or supplementing those contained in this Agreement, and all members will be obligated to comply with such rules, regulations or policies. If new or amended rules or regulations are adopted, they will be published as “Additional or Substitute Rules and Regulations” unless they are of such a nature that publication would be inefficient or inappropriate, in which case notice shall be posted or members shall be otherwise advised of the amendment or supplement to the Rules and Regulations as necessary.

SECTION 7. Enforcement. If any provision of this Agreement or any supplement hereto is ruled invalid or unenforceable as applied to any person or circumstance, all other provisions of this Agreement shall remain valid and enforceable as applied to all other persons and circumstances.

SECTION 8. Agreement Modification. This Membership Agreement constitutes the entire and exclusive agreement of the parties, and supersedes all previous understandings and agreements between the parties, whether oral or written. Modifications or additions to the pre-printed terms of this Agreement, other than the completion of existing blanks, are unauthorized and will not be honored by the Operator. The terms of the Membership Agreement may only be modified in writing, on separate documentation, and any such modification must be signed and dated by both parties.

ARTICLE II. EXAMPLE TERMS FOR RELEASE AND WAIVER OF LIABILITY & ASSUMPTION OF RISK & INDEMNIFICATION AGREEMENT
Member enters into this Release and Waiver, and Assumption of Risk, for Member and for any and all of Member’s guests and Member’s minor children who Member permits to use the Facilities with or without supervision.

In consideration of being permitted to enter upon, participate in and use the facilities, equipment, services and activities of or offered by Watt Plaza and Active Wellness LLC, (including, without limitation, fitness programs offered via the internet or otherwise offsite (“Remote Programs”)), and their agents, owners, directors, officers, employees, partners, independent contractors, volunteers, and all other persons acting in any capacity on their behalf (collectively, the “Fitness Center Parties”), I, on behalf of myself, my guests, children, heirs, executors, administrators, successors and assigns, hereby:

1.             Acknowledge, understand and appreciate that my entry upon and/or use of the facilities, equipment, services and activities, including Remote Programs, of or offered by Fitness Center Parties entails significant risks, both known and unknown, including, without limitation, the possibility of physical or emotional injury, infectious diseases (viral or bacterial, including but not limited to COVID-19), paralysis, death, other serious or catastrophic personal injuries, and loss or damage to personal property.

2.             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 and use of the facilities, equipment, services and activities, including Remote Programs, of or offered by Fitness Center Parties, whether such risks are caused or alleged to be caused by the negligent (actively or passively) acts or omissions of any Fitness Center 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 Fitness Center 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 facilities, equipment, services and activities, including Remote Programs, of or offered by Fitness Center Parties, whether or not supervised by a Fitness Center Party.

3.             Expressly and voluntarily release and forever discharge each of Fitness Center 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 facilities, equipment, services or activities, including Remote Programs, of or offered by Fitness Center Parties, whether the same arises out of or results from any act, omission or conduct of one or more of Fitness Center Parties, negligent (actively or passively) or otherwise.

4.             Expressly agree to hold harmless, indemnify and defend each of Fitness Center Parties (with attorneys of each Fitness Center 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 or use of the facilities, equipment, services or activities, including Remote Programs, of or offered by Fitness Center Parties, whether the same arises out of or results from any act, omission or conduct of one of more of Fitness Center Parties, negligent (actively or passively) or otherwise. The agreement by me to hold harmless, indemnify and defend Fitness Center 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 Fitness Center Parties includes all consequential damages incurred by Fitness Center Parties, or which otherwise would be incurred by Fitness Center 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 Fitness Center Parties, and any other damages incurred by Fitness Center 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.

5.             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 A WATT PLAZA PARTY 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.

ARTICLE III. MEMBERSHIP
SECTION 1: NATURE OF MEMBERSHIP

Membership confers solely the right to use and enjoy certain facilities in accordance with the Fitness Center rules and regulations, as they may change from time to time. “Facilities” means the Fitness Center or other sites included in the membership privileges for the type of membership selected by Member on page 1 of this Agreement,

if any. Membership does not confer any interest in the property or assets of the Fitness Center or owner or any right to participate in the management or operations of the Fitness Center, financially or otherwise.

SECTION 2: FEES & CHARGES

Registration Fees. As a condition of membership, Member shall pay a registration fee to the Operator. The amount, manner and time of payment of such fee shall be established by the Operator and may be changed from time to time. No portion of such fee will be refunded, except as provided in the Initial 10-Day Cancellation Policy as specified on page 1 of this Agreement.

Dues. Member shall pay dues each month pursuant to an electronic funds transfer (EFT) as set forth on page 1 of this Agreement and may terminate his/her membership in accordance with the resignation procedures outlined in Article III, Section 4 of this Agreement. The dues for each category of membership shall be subject to change. The amount of such dues will be automatically transferred from Member’s bank account or credit card once each month on or after the due date for payment. A service fee may be assessed each month if the Operator is unable, for any reason, to receive payment via EFT for any and all dues and/or charges owed to the Operator. Member will pay the dues of any and all additional members added to the Member’s membership. If Member elects to prepay his/her dues in advance, at the end of the prepaid period his/her membership dues will automatically revert to monthly dues billing.

Club Charges. Member may establish club charging privileges by providing a credit or debit card account authorization where indicated on page 1 of this Agreement. Such account information is stored electronically by the Operator for purchases by Member of in-house goods and services which are billed on the date of purchase and reflected on Member’s credit or debit card statement. Any such club charge account information is stored electronically and will not be present at the time of purchase.

Late or Returned Item Charges. A late fee will be assessed for returned checks, insufficient funds, closed accounts, frozen or declined credit cards or similar circumstances, which result in late or delayed payment to the Operator. Member is responsible for providing accurate and updated information on their EFT account to insure timely receipt of payment. Operator reserves the right to re-attempt collection of Member’s outstanding balance until such time as Member’s account is current.

Debit Cards. The processing date for debit cards may vary due to banking procedures and if charges are returned they will be subject to a late fee.

SECTION 3: FACILITIES & ACCESS

Facility Privileges. Privileges to use one or more Facilities vary depending upon the type of membership selected by Member, which is set forth on page 1 of this Agreement and may be changed from time to time.

Unavailability of Facilities. The obligation to pay dues is not dependent on the availability of all or any particular facilities of the Fitness Center at all times, or the type or quantity of the classes or equipment offered at the Fitness Center. If at any time during the term of the contract, including a transfer of the contractual obligation, the Operator eliminates or substantially reduces the scope of the facilities of the Fitness Center, such as swimming pools or tennis courts, that were described in the contract, in an advertisement or other marketing materials (including those on the Fitness Center prior to the same opening for business) relating to the specific location, or in a written offer, and available to Member upon execution of this Agreement, Member may cancel the Agreement and receive a pro-rated refund. Member may not cancel the contract pursuant to this subdivision if the Operator after giving reasonable notice, temporarily takes facilities out of operation for reasonable repairs, modifications, substitutions, or

improvements. This subdivision shall not be interpreted to give Member the right to cancel the Agreement because of changes to the type or quantity of classes or equipment offered, provided Member is informed in the contract that the Operator reserves the right to make changes to the type or quantity of classes or equipment offered and the changes to the type or quantity of classes or equipment offered are reasonable under the circumstances.

SECTION 4: RESIGNATION & TERMINATION
Voluntary Resignation. Member may resign from Watt Plaza at any time by giving written notice to Watt Plaza via signed and dated online web form as provided by Watt Plaza's website at https://www.waiverking.com/print/56457. Written resignation notices can also be accepted via certified mail or an email to an active, valid email address of the Watt Plaza management team. Member can inquire with the Service Desk to confirm valid email addresses of the management team. Member will have access to Watt Plaza for the remainder of the then-current billing cycle for which Member has already paid. After Member’s resignation has become effective, he/she will not be subject to any further dues and all membership privileges will be terminated. Unless otherwise noted, all members on a family or corporate membership will be converted to individual memberships and subject to the dues of that category upon termination of this membership. If membership dues were prepaid, cancellation of membership within the prepaid time period will negate any prepayment discount and any refund will be calculated accordingly taking into account the full, non-discounted dues owing for such period.
Involuntary Termination. The Fitness Center Parties reserves the right at any time to decline, suspend, or terminate the membership or privileges of any member for failure to comply with the terms of this Agreement or with any rules and regulations adopted by The Fitness Center Parties, or for any conduct The Fitness Center Parties determines in its discretion to be improper or in any way contrary to the best interest of The Fitness Center Parties and its membership, or due to a member or applicant's criminal conviction history. Membership may be terminated by written notification mailed to the last address shown on The Fitness Center’s Parties records for the member being terminated. The terminated member will remain liable for all dues and other indebtedness incurred prior to the date of termination, which shall be three (3) business days following the date on which the termination notice is mailed by The Fitness Center Party.

Disability or Death. If Member is unable to use the Fitness Center as provided herein due to disability or death, he/she or his/her estate may terminate this Agreement and shall be relieved of the obligation to pay for services hereunder, and shall be refunded any amounts prepaid for such services, other than those received prior to death or the onset of disability. As used herein, the term “disability” means a condition that precludes Member from physically using the Fitness Center as verified in writing by a physician.

The written notice must be mailed by certified mail to the following address:

Watt Plaza
1875 / 1925 Century Park East
Los Angeles, CA 90067

Resale of Membership. Member may not sell or otherwise transfer membership to another party.

SECTION 5: INTENTIONALLY OMITTED

ARTICLE IV. RULES & REGULATIONS

SECTION 1: Registration. Member must swipe his/her access card against the security card reader and follow any additional self-check in procedures, as may be adopted from time to time, each time he/she uses the Fitness Center. Member may not “tailgate” or “piggyback” off of other members or to the extent possible allow other members to “tailgate” or “piggyback” off of Member. No guests will be permitted to use the Fitness Center. Access cards may only be used by Member and may never be loaned or shared. Member will cooperate with Operator’s staff in verifying the identity of Member during routine or ad hoc checks. Failure to abide by any of the provisions in this section will result in the permanent termination of membership.

SECTION 2: Attire. Proper attire is required for participants using any Facilities. Shirts and shoes are required in all public and recreational areas. The Operator may prohibit the use of any personal equipment on the premises of any Facilities.

SECTION 3: Damages. Any damage caused by Member, Member’s family members (including dependent children) or Member’s guest to any property of the Fitness Center owner (if not the Fitness Center) or another person at any Facilities shall be paid for by Member.

SECTION 4. Hours of Operation. The hours of operation are adjusted seasonally and in accordance with the frequency of member usage. The Operator reserves the right to change the operating hours of the Fitness Center. Members are not allowed to be in the Fitness Center other than the hours designated by Operator from time-to-time.

SECTION 5. Minors and Children. Persons between the age of thirteen (13) and seventeen (17) must be accompanied by an adult member at all times while using any Facilities. Children through the age of twelve (12) are not allowed in any Facilities.

SECTION 6. Personal Business. Members may not use any Facilities for personal business without prior written approval by an authorized representative of the Operator. No smoking, alcoholic beverages or glassware is allowed in or around the Fitness Center at any time.

SECTION 7. Replacement Items. Lost or stolen membership cards and locker keys will be subject to a replacement fee.

SECTION 8. Risk and Medical. All Members shall use the Fitness Center, any and all equipment and participate in any exercise, program or class at their own risk. Those Members with medical conditions such as high blood pressure, heart disease, respiratory problems or any other conditions or situations which may make any form of exercise dangerous to one’s health, such as pregnancy or medication(s), must consult with and receive consent from their physician prior to joining and/or using the Fitness Center. If any Member feels faint, dizzy, sick, experiences pain and/or has difficulty breathing while using the Fitness Center, such Member shall immediately stop the activity and cool down. In the event such Member does not feel better, he/she promptly shall call 911 for assistance.

SECTION 9. Equipment. In the event a Member notices any faulty or malfunctioning equipment, hazardous conditions, situations, or safety concerns, while using the Fitness Center for any reason, such Member shall report the situation to the management or building staff personnel immediately. Members agree to keep the Fitness Center in a neat and orderly fashion, including, but not limited to, wiping all equipment after use. Members agree to read equipment instructions prior to use of any fitness equipment.

SECTION 10. Additional Rules and Regulations. Management reserves the right to change membership fees, alter Fitness Center hours of operation, or add, change or delete any of the rules and regulations of this Fitness Center as may from time to time be deemed necessary in the sole and absolute discretion of management. Member also agrees to abide by any additional rules and regulations as posted in the Fitness Center.

SECTION 11. Without limiting the foregoing, with respect to personal trainers: trainers are only allowed to train at Watt Plaza upon request of a member of the club; the member must provide the trainer with access to the club; the trainer is not allowed access to the club outside of scheduled training sessions; the trainer is required to sign the Training Addendum provided by Watt Plaza in order to provide training services. The trainer is also required to provide Active Wellness all documentation detailed in the Training Addendum. Training privileges can be revoked at any time at the discretion of club management.

Warning: Use of steroids to increase strength or growth can cause serious health problems. Steroids can keep teenagers from growing to their full height; they can also cause heart disease, stroke, and damaged liver function. Men and women using steroids may develop fertility problems, personality changes, and acne. Men can also experience premature balding and development of breast tissue. These health hazards are in addition to the civil and criminal penalties for unauthorized sale, use, or exchange of anabolic steroids.

PHOTO RELEASE
I understand that while participating in activities at Watt Plaza, I may be photographed or filmed. I hereby assign copyright of the resulting images to Active Wellness, LLC together with the right of reproduction either wholly or in part, including in advertising and promotion, and I undertake not to prosecute or to institute proceedings, claims or demands against Active Wellness, LLC or its agents in respect of any reasonable usage of the above mentioned photographs or footage.

MEMBER RESPONSIBILITY CODE OF CONDUCT
All members need to be knowledgeable of and responsible for complying with safe and healthful conduct to minimize the risk of communicable diseases. We ask members to follow the guidelines below:

Members who feel ill should stay home, follow appropriate self-care guidelines and/or contact their health care provider.

Members who have tested positive for COVID-19, or have knowingly come into close contact with someone who has, are not to come to the facility for 14 days or until they have tested negative for COVID-19.

Wear masks or face shields that cover the nose, mouth and chin as requested by Active and/or government mandates.

Do not engage in hand shaking, fist bumping, high-fiving or any other person-to-person contact.

Practice physical distancing by maintaining a distance of six feet from others and observing floor and wall signage related to physical distancing expectations.

Wash hands frequently with water and soap for at least 20 seconds before entering the facility, after leaving the facility, and as needed during visits.

If soap and running water are not immediately available, use hand sanitizer that contains at least 60% alcohol. Hand sanitizing stations are placed throughout the facility.

Cover their mouth and nose when coughing or sneezing. Follow-up Immediately with hand washing or sanitizer as noted above.

Avoid gathering in communal areas with other members where physical distancing expectations may be compromised.

Follow all equipment cleaning protocols as defined by site management. Wipe down every piece of equipment BEFORE use and again immediately AFTER use.

Support Active’s commitment to providing a safe environment for all by reporting incidents of non-compliance by others to Active staff.

Be kind and patient - we’re all learning how to adapt to this new normal.

Member Name:
* Member Signature:

Clear

(draw your signature)

Date:

1875 / 1925 Century Park East • Los Angeles, CA 90067 • phone 310.789.2179

PAR-Q
The Physical Activity Readiness Questionnaire for Everyone

The health benefits of regular physical activity are clear; more people should engage in physical activity every day of the week. Participating in physical activity is very safe for MOST people. This questionnaire will tell you whether it is necessary for you to seek further advice from your doctor OR a qualified exercise professional before becoming more physically active.

GENERAL HEALTH QUESTIONS
Please read the 7 questions below carefully and answer each one honestly. Check:		YES or NO
1.	Has your doctor ever said that you have a heart condition OR high blood pressure?
2.	Do you feel pain in your chest at rest, during your daily activities of living, OR when you do physical activity?
3.	Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months? Please answer NO if your dizziness was associated with over-breathing (including during vigorous exercise).
4.	Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)?
5.	Are you currently taking prescribed medications for a chronic medical condition?
6.	Do you currently have (or have had within the past 12 months) a bone, joint, or soft tissue (muscle, ligament, or tendon) problem that could be made worse by becoming more physically active? Please answer NO if you had a problem in the past, but it does not limit your current ability to be physically active.
7.	Has your doctor ever said that you should only do medically supervised physical activity?

If you answered NO to all of the questions above, you are cleared for physical activity.

Start becoming much more physically active – start slowly and build up gradually.
Follow Global Physical Activity Guidelines for your age (https://www.who.int/publications/i/item/9789240015128).
You may take part in a health and fitness appraisal. If you are over the age of 45 yr and NOT accustomed to regular vigorous to maximal effort exercise, consult a qualified exercise professional before engaging in this intensity of exercise.
If you have any further questions, contact a qualified exercise professional.

If you answered YES to one or more of the questions above:

Talk with your doctor by phone or in person BEFORE you start becoming much more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES.
You may be able to do any activity you want - as long as your start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.
Find out which community programs are safe and helpful for you.

Delay becoming more active if:

You have a temporary illness such as a cold or fever; it is best to wait until you feel better.
You are pregnant - talk to your health care practitioner, your physician, a qualified exercise professional, and/or complete the ePARmed-X+ at www.eparmedx.com before becoming more physically active.
Your health changes - answer the questions on Pages 2 and 3 of this document and/or talk to your doctor or a qualified exercise professional before continuing with any physical activity program.

If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity

Informed Use of the PAR-Q: The Canadian Society for Exercise Physiology, Health Canada, and their agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity. “I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction.”

Note: This physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if your condition changes so that you would answer YES to any of the seven questions.

1875 / 1925 Century Park East • Los Angeles, CA 90067 • phone 310.789.2179

Name of Adult Participant and/or Parent or Legal Guardian of Minor:

First Name:	Last Name:	Birth Date:
Address:	City:	State:
Zip:	Email:	Phone:

Relationship to minor:

Full Name and Birth Date of family members under the age of 18

#1	First Name:	Last Name:	Birth Date:
#2	First Name:	Last Name:	Birth Date:
#3	First Name:	Last Name:	Birth Date:
#4	First Name:	Last Name:	Birth Date:
#5	First Name:	Last Name:	Birth Date:
#6	First Name:	Last Name:	Birth Date:
#7	First Name:	Last Name:	Birth Date:
#8	First Name:	Last Name:	Birth Date:
#9	First Name:	Last Name:	Birth Date:
#10	First Name:	Last Name:	Birth Date:

Put Your Legal Signature Below

Clear

Date and Time Signed:

By checking this box I agree to have read and agree to the legal agreement above.

Send me emails about Account Management, Reminders, and Schedule Changes

Send a copy of this form to my Email

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Our Privacy Policy

PLEASE NOTE THAT WAIVERKING, INC.’S (“WaiverKing”) PRIVACY POLICY HAS CHANGED EFFECTIVE May 25th, 2018.

You acknowledge that this privacy policy is a part of our website’s Terms of Service, and by accessing or using our website, you agree to be bound by all of its terms and conditions. IF YOU DO NOT AGREE TO THESE TERMS, AS UPDATED, PLEASE IMMEDIATELY STOP ACCESSING THE WEBSITE.

This document explains how we use your personal data.

When you sign up to use this service provider’s services, you do so through software provided by us, WaiverKing.

We are committed to ensuring the privacy of all users of our software and services and other visitors to our website. In this policy we explain how we hold, process and retain your personal data.

In respect to the account data, waiver data, and payment data (as defined below) that you provide to us, we are acting as a data processor on behalf of the service provider, who will be acting as the data controller in respect to such data. We will never store or control this data. You should direct any requests or queries you have regarding this data to the data controller, your service provider.

1. How we use your personal data

1.1. This section provides you with information about:

a) what personal data we hold and process;

b) in respect of personal data that we did not collect from you directly, where we obtained that data from, and what types of data we have collected;

c) the purposes for which we may process your personal data; and

d) the legal grounds on which we process your data.

Members and end users of our services

1.2. Account data. We may process information about you that you provide to us when you first sign up with a service provider ("account data"). This account data may include your name, address, telephone number, email address, date of birth, gender, employment details, and a photograph of you. We may use this data to create your account with the service provider when you sign up. This account data may be updated each time you complete a document through our software. We do not process your account data in any other way, or have access to it in any way.

The legal basis for this processing is our legitimate interests in providing our services to our clients, and ensuring that your account is updated each time that you complete a document through our software.

1.3. Waiver data. If you are using our software in order to sign documents such as a waiver, health form, contract, or questionnaire, we may process information that you put into such documents (“waiver data”). This waiver data may include your name, signature, date of birth, email address, information about your health and medical history, and any other information that you are required or requested to put into the document.

Once you have completed the document, we will process it, convert the document into a different format, and send it to your account with the service provider in order for it to be stored. We will never store your data permanently on our systems (although it may be stored in your account with your service provider).

The purpose for our processing your data in this way is to maintain and administer a complete and accurate record of the documents that you have signed and completed for your service provider. The legal basis for our processing your waiver data (to the extent that such waiver data does not class as a special category of personal data), will be our legitimate interests in providing our services to our clients who have asked you to complete the document in question, in order to ensure that a complete and accurate record of your signing and completing the documents is maintained and administered.

1.4. Sensitive Personal Data. During the course of using our software and services and providing us with information in order for us to provide our services to you, you may provide us with sensitive information about yourself (“sensitive data”). This sensitive data may include your health and medical history. We may use this data for providing our services to you. However, we will only process this sensitive data if you consent to us doing so.

[The consent to use this information needs to be provided by the parent for children under the age of 13. Anyone over the age of 13 can provide consent for use of their data under GDPR]

We comply with the requirements of the Children’s Online Privacy Protection Act. You must be at least 18 years old to have our permission to use the WaiverKing website. If you are between the ages of 13 and 17, or under the age of majority where you live, you represent that your legal guardian has reviewed and agreed to this privacy policy.

Other processing that we may carry out

1.5. Website data. We may process data about your use of our website and services ("website data"). The website data may include your IP address, geographical location, browser type and version, operating system, referral source, length of visit, page views and website navigation paths, as well as information about the timing, frequency and pattern of your service use. The source of the website data is our analytics tracking system. This website data may be processed for the purposes of analyzing the use of the website and services.

The legal basis for this processing is our legitimate interests, namely monitoring and improving our website and services.

We may also process this data for the purposes of diagnosing any issues we detect in relation to the use of our products or services. This data may be collected by our error-tracking software which is provided by Rollbar. We always try to ensure that any such data is anonymized so that you cannot be identified before it is stored in our records.

The legal basis for this processing is our legitimate interests in monitoring and improving our products and services.

1.6. Enquiry data. We may process information contained in any enquiry you submit to us regarding our products or services ("enquiry data"). The enquiry data may be processed for the purposes of offering, marketing and selling relevant products and/or services to you.

The legal basis for this processing is our legitimate interests, namely dealing with and responding to your enquiry appropriately.

1.7. Notification data. We may process information that you provide to us for the purpose of subscribing to our blog and press releases ("notification data"). The notification data may be processed for the purposes of sending you newsletters.

Where you are a corporate customer, the legal basis for this processing is our legitimate interests, namely the marketing of relevant products and services to you.

1.8. Correspondence data. We may process information contained in or relating to any communication that you send to us ("correspondence data"). The correspondence data may include the communication content and metadata associated with the communication. Our website will generate the metadata associated with communications made using the website contact forms. The correspondence data may be processed for the purposes of communicating with you and record-keeping.

The legal basis for this processing is our legitimate interests, namely the proper administration of our website and business and communications with users.

1.9. Payment data. We do not process payment information relating to goods and services that you purchase from the service provider. However, we do capture certain data relating to your payments and use them to update your account with the service provider ("payment data"). The payment data may include your contact details, your card details and the transaction details. The payment data may be processed for the purposes of updating your account with the service provider. The legal basis for this processing is our legitimate interests, namely our interest in the proper administration of our software and ensuring your account with the service provider is updated.

1.10. Other processing activities. In addition to the specific purposes for which we may process your personal data set out above, we may also process any of your personal data where such processing is necessary for compliance with a legal obligation to which we are subject, or in order to protect your vital interests or the vital interests of another natural person.

2. Providing your personal data to others

2.1. To our clients and partner service providers. The only third parties that we will disclose your personal data to are our clients (your service provider) who is the data controller in respect to the account data, waiver data, and payment data that we collect about you, and MINDBODY Inc. (“MINDBODY”), who provide software services to service providers in conjunction with the WaiverKing software. Your accounts are created by WaiverKing in the MINDBODY software on behalf of our clients.

2.2. Our insurers/professional advisers. We may disclose your personal data to our insurers, legal counsel, and/or professional advisers insofar as reasonably necessary for the purposes of obtaining and maintaining insurance coverage, managing risks, obtaining professional advice and managing legal disputes.

2.3. Where we provide your personal data to any third party. Where we share your personal data with any of the third parties referred to above, we will ensure this processing is protected by appropriate safeguards including a suitable data processing agreement with that third party.

2.4. To comply with legal obligations. In addition to the specific disclosures of personal data detailed above, we may also disclose your personal data where such disclosure is necessary for compliance with a legal obligation we have to comply with, or in order to protect your vital interests or the vital interests of another individual. This may include disclosing your personal data in response to lawful requests by public authorities, including to meet national security or law enforcement requirements.

2.5. We take reasonable and appropriate steps to ensure that third-party agents and service providers process your personal data in accordance with our Privacy Shield obligations and to stop and remediate any unauthorized processing. Under certain circumstances and pursuant to applicable laws, we may remain liable for the acts of our third-party agents or service providers who perform services on our behalf for their handling of your personal data that we transfer to them.

3. Transfers of your personal data outside of the European Economic Area

As further detailed below, we may transfer your personal data to our servers based in the US, as we are part of the Privacy Shield. Otherwise, where your personal data is transferred outside of the EEA, we will ensure that either (a) The European Commission has made an "adequacy decision" with respect to the data protection laws of the country to which it is transferred, or (b) we have entered into a suitable data processing agreement with the third party situated in that country to ensure the adequate protection of your data. In all cases, transfers outside of the EEA will be protected by appropriate safeguards.

4. Retaining and deleting personal data

4.1. Personal data that we process for any purpose or purposes shall not be kept for longer than is necessary for that purpose or those purposes. Details about members of our clients (your service provider) and end users of our services, including the account data, waiver data and sensitive personal data, will not be stored by WaiverKing.

4.2. Unless we contact you and obtain your consent for us to retain your personal data for a longer period, we will retain and delete your personal data as follows:

a) Website data will be retained for 12 months following the date of our last contact or dealing with you, at the end of which period it will be deleted from our systems.

b) Enquiry data will be retained for 12 months following the date of our last contact or dealing with you, at the end of which period it will be deleted from our systems.

c) Notification data (other than Notification data that is also Contact data) will be retained for 12 months following the date of our last contact or dealing with you, at the end of which period it will be deleted from our systems.

d) Correspondence data will be retained for 12 months following the date of our last contact or dealing with you, at the end of which period it will be deleted from our systems.

4.3. We may retain your personal data where such retention is advisory and/or necessary for compliance with a legal obligation to which we are subject (such as with regard to applicable statutes of limitations, litigation or regulatory investigations), or in order to protect your vital interests or the vital interests of another natural person.

5. Your rights

5.1. You may instruct us to provide you with any personal information we hold about you; provision of such information will be subject to:

a) your request not being found to be unfounded or excessive, in which case a charge may apply; and

b) the supply of appropriate evidence of your identity (for this purpose, we will usually accept a notarized photocopy of your driver’s license and/or passport and an original copy of a utility bill showing your current address).

5.2. We may withhold personal information that you request to the extent permitted by law.

5.3. You may instruct us at any time not to process your personal information for marketing purposes.

5.4. In practice, you will usually expressly agree in advance to our use of your personal information for marketing purposes, or we will provide you with an opportunity to opt out of the use of your personal information for marketing purposes.

5.5. Your right to access your data. You have the right to ask us to confirm whether or not we process your personal data and, to have access to the personal data, and any additional information. That additional information includes the purposes for which we process your data, the categories of personal data we hold and the recipients of that personal data. You may request a copy of your personal data. The first copy will be provided free of charge, but we may charge a reasonable fee for additional copies.

5.6. Your right to correct. If we hold any inaccurate personal data about you, you have the right to have these inaccuracies corrected. Where necessary for the purposes of the processing, you also have the right to have any incomplete personal data about you completed.

5.7. Your right to erasure. In certain circumstances you have the right to have personal data that we hold about you erased. This will be done without undue delay. These circumstances include the following: (1) it is no longer necessary for us to hold those personal data in relation to the purposes for which they were originally collected or otherwise processed; (2) you withdraw your consent to any processing which requires consent; (3) the processing is for direct marketing purposes; and/or (4) the personal data have been unlawfully processed. However, there are certain general exclusions of the right to erasure, including where processing is necessary: for exercising the right of freedom of expression and information; for compliance with a legal obligation; or for establishing, exercising or defending legal claims.

5.8. Your right to restrict processing. In certain circumstances you have the right for the processing of your personal data to be restricted. These circumstances include the following: (1) you do not think that the personal data we hold about you is accurate; (2) your data is being processed unlawfully, but you do not want your data to be erased; (3) it is no longer necessary for us to hold your personal data for the purposes of our processing, but you still require that personal data in relation to a legal claim; and/or (4)you have objected to processing, and are waiting for that objection to be verified. Where processing has been restricted for one of these reasons, we may continue to store your personal data. However, we will only process it for other reasons: with your consent; in relation to a legal claim; for the protection of the rights of another natural or legal person; or for reasons of important public interest.

5.9. Your right to object to processing. You can object to us processing your personal data where our legal basis for the processing is that it is necessary for: the performance of a task carried out in the public interest, or in the exercise of any official authority vested in us; or the purposes of our legitimate interests or those of a third party. If you make an objection, we will stop processing your personal information unless we are able to: demonstrate compelling legitimate grounds for the processing, and that these legitimate grounds override your interests, rights and freedoms; or the processing is in relation to a legal claim.

5.10. Your right to object to direct marketing. You can object to us processing your personal data for direct marketing purposes. If you make an objection, we will stop processing your personal data for this purpose.

5.11. Your right to data portability. Where you have given us consent to process your personal data, or where we are processing your personal data for the performance of a contract, you have a legal right to receive a copy of the personal data we hold about you in a structured, commonly used and computer readable format. When a data request is made of us we will make available all applicable personal data to you in a computer readable format and will transmit your personal data to the appropriate third party pursuant to your instruction. We will not process your data in this way if we believe that it may pose a threat to the security of the data.

5.12. Your right to object for statistical purposes. You can object to us processing your personal data for statistical purposes on grounds relating to your particular situation, unless the processing is necessary for performing a task carried out for reasons of public interest.

5.13. Automated data processing. To the extent that the legal basis we are relying on for processing your personal data is consent, and where the processing is automated, you are entitled to receive your personal data from us in a structured, commonly used and computer-readable format. However, you may not have this right if it would adversely affect the rights and freedoms of others.

5.14. Complaints to a supervisory authority pursuant to the GDPR. If you think that our processing of your personal data infringes data protection laws, you can lodge a complaint with a supervisory authority responsible for data protection. You may do this in the EU member state of your habitual residence, your place of work or the place of the alleged infringement. This provision is only applicable if you are subject to the protections of the GDPR.

5.15. Complaints if you are not subject to the protections of the GDPR. If you think that our processing of your personal data infringes data protection laws you may contact us via email at privacy@waiverking.com or mail at: WaiverKing, Inc. 340 S Lemon Ave # 2018 Walnut, California 91789.

5.16. Right to withdraw consent. To the extent that the legal basis we are relying on for processing your personal data is consent, you are entitled to withdraw that consent at any time. Withdrawal will not affect the lawfulness of processing before the withdrawal.

5.17. Exercising your rights. You may exercise any of your rights in relation to your personal data by written notice to us in addition to the other methods specified above.

5.18. Point of Contact Data. PARAGRAPHS 5.1 – 5.17 SHALL NOT APPLY TO ACCOUNT DATA, WAIVER DATA, OR PAYMENT DATA OBTAINED OR PROCESSED BY WAIVERKING. IN RESPECT OF SUCH DATA:

a) WAIVERKING IS ACTING AS A PROCESSOR OF THAT DATA AND THE MAIN CONTRACTOR IS THE CONTROLLER;

b) YOU SHOULD CONTACT THE SERVICE PROVIDER TO EXERCISE THE RIGHTS SET OUT IN THIS PARAGRAPH 5

6. Links To Other Websites. Except as otherwise discussed in this privacy policy, this document only addresses the use and disclosure of information we collect from you. Other websites accessible through our website have their own privacy policies and data collection, use, and disclosure practices. Please consult each website’s privacy policy. We are not responsible for the policies or practices of third parties, including any third-party site or other products and services used in connection with WaiverKing’s services. The inclusion of a link does not imply endorsement of the linked site or service by us or by our affiliates.

We are not responsible for the collection, usage and disclosure policies and practices (including the data security practices) of other organizations, such as, Apple, Google, Microsoft, or any other operating system provider, wireless service provider or device manufacturer, including any personal data you disclose to other organizations through or in connection with WaiverKing’s services.

7. Security of Your Information. The security of personal data is a high priority at WaiverKing. We seek to use reasonable technical, administrative and physical safeguards to protect personal data within our organization. Unfortunately, no data transmission or storage system can be guaranteed to be 100% secure. As a result, while we strive to protect your personal data, you acknowledge that: (a) there are security and privacy limitations of the Internet which are beyond our control; (b) the security, integrity, and privacy of any and all information and data exchanged between you and us through the website cannot be guaranteed; and (c) any such information and data may be viewed or tampered with in transit by a third party.

8. IP Addresses and Cookies. Cookies are very small text files that are stored on your computer when you visit some websites.

We use cookies to help identify your computer, including where available, your IP address, operating system and browser type, for system administration so we can keep your activity secure, tailor your user experience and remember your preferences. This is statistical data and does not identify any individual. You are always free to decline our cookies if your browser permits, but some parts of our website may not work properly.

9. Your California Privacy Rights: Notice to California Customers and Opt-Out Information. Residents of the State of California, under certain provisions of the California Civil Code, have the right to request from companies conducting business in California a list of all third parties to which the company has disclosed certain personal data, as defined under California law, during the preceding year for third party direct marketing purposes. You are limited to one request per calendar year. In your request, you must supply appropriate evidence of your identity and attest to the fact that you are a California resident and provide a current California address for our response. You may request the information by writing to privacy@waiverking.com

Some web browsers incorporate a “Do Not Track” feature that signals to websites that you visit that you do not want to have your online activity tracked. California residents are entitled to know how WaiverKing, Inc. responds to “Do Not Track” signals. How browsers communicate the Do Not Track signal is not yet uniform, so a standard technological response has not yet been developed by the appropriate technology communities. For this reason, we do not respond to Do Not Track signals currently. To opt out of direct advertising on our website, please send a request to the address above. The effect of an opt-out will be to stop direct advertising, but it will still allow the collection of usage data for certain purposes (e.g., research, analytics, and internal online services operation purposes).

10. Privacy Shield Framework

10.1. WaiverKing Inc. complies with the EU-U.S. and Swiss-U.S. Privacy Shield Framework as set forth by the U.S. Department of Commerce regarding the collection, use, and retention of personal information transferred from the European Union and Switzerland to the United States. WaiverKing has certified to the Department of Commerce that it adheres to the Privacy Shield Principles. If there is any conflict between the terms in this privacy policy and the Privacy Shield Principles, the Privacy Shield Principles shall govern. To learn more about the Privacy Shield program, and to view our certification, please visit https://www.privacyshield.gov/

10.2. In compliance with the Privacy Shield Principles, WaiverKing commits to resolve complaints about our collection or use of your personal information. Any individual(s) with inquiries or complaints regarding our Privacy Shield policy should contact us at: privacy@waiverking.com

10.3. WaiverKing Inc. has further committed to refer unresolved Privacy Shield complaints to Judicial Arbitration and Mediation Services (JAMS), an alternative dispute resolution provider located in the United States. If you do not receive timely acknowledgment of your complaint from us, or if we have not addressed your complaint to your satisfaction, please visit https://www.jamsadr.com/eu-us-privacy-shield for more information or to file a complaint. The services of JAMS are provided at no cost to you. In certain situations, you may also have the right to pursue binding arbitration under the Privacy Shield Framework.

10.4. You may have the option to select binding arbitration for the resolution of your complaint under certain circumstances, provided you have taken the following steps: (1) raised your complaint directly with WaiverKing Inc. and provided us the opportunity to resolve the issue; (2) made use of the independent dispute resolution mechanism identified above; and (3) raised the issue through the relevant data protection authority and allowed the U.S. Department of Commerce an opportunity to resolve the complaint at no cost to you. For more information on binding arbitration, see U.S. Department of Commerce's Privacy Shield Framework: Annex I (Binding Arbitration).

10.5. For purposes of enforcing compliance with the Privacy Shield, WaiverKing is subject to the investigatory and enforcement authority of the U.S. Federal Trade Commission.

10.6. WaiverKing Inc. is controlled and operated by us from the United States. Except where you are a resident of a Member State of the EU, in which case paragraphs 2 and 3 above will apply, your personal data may be stored and processed in any country in which we engage service providers, and by using WaiverKing’s services you understand that your information may be transferred to countries outside of your country of residence, including the United States, which may have data protection rules that are different from those of your country. In certain circumstances, courts, law enforcement agencies, regulatory agencies or security authorities in those other countries may be entitled to access your personal data. Regardless of where your information is processed, we apply the same protections described in this policy.

11. Changes to the privacy policy. We reserve the right to change this policy at any time, without prior notice to you. Such changes, modifications, additions, or deletions shall be effective immediately upon notice thereof, which may be given by means including, but not limited to, issuing an e-mail to the e-mail address provided by you or posting the revised policy on this page. You acknowledge and agree that it is your responsibility to maintain a valid e-mail address and/or review the WaiverKing website and this policy periodically, and be aware of any modifications. Your continued use of the WaiverKing website after such modifications will constitute your: (a) acknowledgment of the modified policy; and (b) agreement to abide and be bound by the modified policy.

12. Our details

12.1. This website and software is owned and operated by WaiverKing Inc.

12.2. We are registered in the state of California under registration number C3518177, and our registered office is at 340 S Lemon Avenue, # 2018 Walnut, California 91789.

12.3. You can contact us:

a) by mail, using the postal address given above;

b) using our website contact form;

c) by telephone, on the contact number published on our website from time to time; or

d) by email, using the email address published on our website from time to time.

13. Data protection officer

Our data protection officer may be contacted via email: privacy@waiverking.com, or telephone: +1 (888) 211-6693.

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