Liability Waiver

NOVA Fitness Health Assessment
Liability Waiver and Release For Demonstration of Visionbody EMS Suit

I acknowledge that this Nova Fitness, Inc. fitness demonstration (the?Nova Fitness Demonstration?) involves strength, flexibility, aerobic, cardio and other exercises, including the use of the Visionbody EMS Suit (the ?EMS Suit?), all of which can be potentially hazardous activities. I am voluntarily agreeing to participate in the Nova Fitness Demonstration and I hereby agree to expressly assume and accept any and all risks of injury, physical harm or death.

I acknowledge and represent that I am 18 years of age or older and physically sound and I do not suffer from any illness, impairment, disease or other condition that would prevent me from participating in the Nova Fitness Demonstration, performing any exercises or using the EMS Suit or any other equipment.

In consideration of being allowed to participate in the Nova Fitness Demonstration, I do hereby knowingly and voluntarily, on behalf of myself and my heirs and assigns, forever waive, release, discharge and hold harmless Nova Fitness, Inc. and its officers, directors, employees, agents, stockholders, subsidiaries and affiliates from any liability, damages, losses, suits, demands, causes of action (including, without limitation, negligence) or other claims of any nature whatsoever, including, without limitation, any losses for property damage, personal injury or death arising out of or relating in any way to my participation in the Nova Fitness Demonstration and its related programs and activities or my use of any facilities, equipment (including the EMS Suit) or machinery in connection with the NovaFitness Demonstration. 

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident and/or illness during the Nova Fitness Demonstration.I have been advised that I cannot engage in the Nova Fitness Demonstration if I have any of the conditions below and I am initialing each to confirm that I do not have: 

- a pacemaker
- any electrocardiographic or other electronic medical devices
- any neurologic disorder including epilepsy or convulsions
- pregnancy 

I have been advised that it is not recommended that I participate in the Nova Fitness Demonstration if I have any of the following: 

- tumor
- infectious disease
- high fever
- blood pressure related illness (unless medically cleared by a physician)
- any skin condition that is open, cut, irritated, flaking, inflamed, red or infected
- a metal implant

I hereby state, after having been advised as set forth above, that I do not have any of the conditions set forth above and know of no reason why I should not engage in the Nova Fitness Demonstration. I further state that, should any of the facts above change in any way, including any physical, mental or medical condition, after I sign this document, I am solely responsible to so advise my personal physician and Nova Fitness.

I further state and acknowledge that no one but me knows how I am reacting during any physical endeavor, including the Nova Fitness Demonstration, and that I will be solely responsible to advise the Nova Fitness trainer if I experience any unusual or severe physical, mental or emotional sensations during the Nova Fitness Demonstration so that I can be protected. If such unusual or severe physical, mental or emotional sensations occur after the Nova Fitness Demonstration, I recognize and acknowledge that it is my sole responsibility to seek medical attention with my personal physician or at an emergency care facility if my personal physician cannot attend to my needs.

I have been advised that the EMS Body Suit is a new device that has not received FDA approval and there are no medical studies regarding the impact or affects of its use.

I represent and acknowledge that I have read and understand this Nova Fitness, Inc. Liability Waiver and Release. My voluntary execution of this form evidences my agreement to the terms, provisions, waivers and releases as set forth above.
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