Waiver and Release of Liability

Built 4 It Athletics LLC​ 550 Industry Way Ste 40 Prosper, TX 75078

Express assumption of risk: Customer is aware that there are significant risks involved in all aspects

of physical training. These risks include, but are not limited to: falls which can result in serious injury

or death, injury or death due to negligence on the part of myself, my training partner, or other people

around me, injury or death due to improper use or failure of equipment. I am aware that any of these

above mentioned risks may result in serious injury or death to myself and or my partner(s). I willingly

assume full responsibility for the risks that I am exposing myself to and accept full responsibility for

any injury or death that may result from participation in any activity or class while at Built 4 It

Athletics LLC. I, the undersigned acknowledge that I have no physical impairments or illnesses that

will endanger myself or others.

Release: In consideration of the above mentioned risks and hazards and in consideration of the fact

that I am willingly and voluntarily participating in the activities available at Built 4 It Athletics LLC, I,

the undersigned hereby release Built 4 It Athletics LLC, their principals, agents, employees, and

volunteers from any and all liability, claims, demands, actions or rights of action, which are related to,

arise out of, or are in any way connected with my participation in this activity, including those

allegedly attributed to the negligent acts or omissions of Built 4 It Athletics LLC, their principals,

agents, employees, and volunteers. This agreement shall be binding upon me, my successors,

representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held

invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. If I am

signing on behalf of a minor child, I also give full permission for any person connected with Built 4 It

Athletics LLC to administer first aid deemed necessary, and in case of serious illness or injury, I give

permission to call for medical and or surgical care for the child and to transport the child to a medical

facility deemed necessary for the well being of the child.

Indemnification: The participant recognizes that there is risk involved in the types of activities offered

by Built 4 It Athletics LLC. Therefore the participant accepts financial responsibility for any injury that

the participant may cause either to him/herself or to any other participant due to his/her negligence.

Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorney's

fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further

agree to indemnify and hold harmless Built 4 It Athletics LLC, their principals, agents, employees,

and volunteers from liability for the injury or death of any person(s) and damage to property that may

result from my negligent or intentional act or omission while participating in activities offered by Built

4 It Athletics LLC.

Both Parties agree as follows: I understand I will receive trigger point dry needling as part of

my physical therapy treatment. Dry needling is an effective physical therapy modality used in

conjunction with other interventions in the treatment of myofascial pain and dysfunction. A solid

filament needle is inserted into the skin and muscle directly at a myofascial trigger point.

A trigger point consists of multiple contraction knots, which are related to the production and

maintenance of the pain cycle. The benefit of dry needling is that it precisely deactivates the trigger

point, leading to biochemical changes that reduce pain.

Risks of dry needling include, but are not limited to post needling soreness, allergic reaction,

vasodepressive syncope (feeling faint), nerve injury, vascular injury, penetration of a visceral organ,

increased spasm, muscle edema, infection, and hematoma. Precautions are taken to avoid all of

these complications.

Acupuncture disclaimer:

Dry needling is a technique used in physical therapy practice to treat trigger points in muscles. You

should understand that this technique should not be confused with a complete acupuncture

treatment performed by a licensed acupuncturist. A complete acupuncture treatment might yield a

holistic benefit not available through a limited dry needling treatment.

Rhabdomyolysis Release: Rhabdomyolysis (hereinafter referred to as "Rhabdo") can occur when an

individual's physical activity is so intense that muscular cells begin to breakdown and the contents

and/or remaining materials enter the bloodstream. Rhabdo may be caused by many other systemic

or environmental causes. However, Exertional Rhabdo can occur in athletes of all levels of fitness,

resulting in muscle cell destruction. The skeletal muscle breakdown impairs kidney function as those

organs are unable to handle increased enzymes that are released into the bloodstream. This induces

severe physiological changes in the body. The symptoms of Rhabdo include muscle pain, stiffness

and extreme weakness, darkening of the urine (similar to the color of tea or cola), decreased urine

output, altered mental status, swelling of the body part involved, either with or without pain. A

Rhabdo symptom is pain out of proportion to the amount of soreness that one would generally

expect, often producing pain much quicker than one would expect after a workout.​

I understand that any concerns on my part that I am experiencing any of the symptoms of Rhabdo

require immediate presentation to a hospital for emergency treatment. I acknowledge that no third

party, either from the facility or otherwise, will be capable of monitoring my urine output or color, and

it is my responsibility to be continually cognizant of this symptom and all other symptoms and to

monitor them in my own body at all times. I agree that I will remove myself from participation and

seek medical treatment of my own accord should I have any concerns regarding possible symptoms

of Rhabdo. I understand that statistically individuals most likely to experience Rhabdo are those who

are in good shape by general standards or who were previously in good physical shape. This

includes individuals who were prior athletes. I acknowledge that often the more mentally tough an

athlete is and the more athletic they were in the past or currently are, the greater the risk of exposure

to Rhabdo.​

I agree to monitor myself in a manner that is proportionate to the potential injury that can be

occasioned by this condition. I acknowledge and understand that I am the only individual capable of

determining if I am experiencing Rhabdo symptoms. I hereby agree and do willingly assume

responsibility for any risks that I expose myself to and accept full responsibility for any injury or death

that may result from participating in this significantly demanding physical activity. I for myself and on

behalf of my heirs, assigns, personal representatives and/or next of kin, forever WAIVE, RELEASE,

DISCHARGE and COVENANT NOT TO SUE and/or their officers, directors, representatives,

partners, officials, principals, agents or employees, subsidiaries, or assigns, as well as their

independent contractors.

COVID-19 Response: In response of the COVID-19 Pandemic, hours of operation and amenities

may vary upon state and local public health mandates. For health and safety of our community,

we've introduced mask requirements, temperature screenings, social distancing practices, deep-

cleaning processes and other safety measures that align with CDC guidelines. We ask that members

and guests who are experiencing symptoms to please stay home and practice safety measures that

align with CDC guidelines.

COVID-19 Release: In consideration of the above mentioned COVID-19 response and in

consideration of the fact that I am willingly and voluntarily participating in the activities available at

Built 4 It Athletics LLC, I, the undersigned hereby release Built 4 It Athletics LLC, their principals,

agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of

action, which are related to, arise out of, or are in any way connected with COVID-19.

I have read and understood the foregoing assumption of risk, and release of liability and I understand

that by signing it obligates me to indemnify the parties named for any liability for injury or death of

any person and damage to property caused by my negligent or intentional act or omission. I

understand that by signing this form I am waiving valuable legal rights.

PARENTAL CONSENT, (for participants under the age of 18) I, the undersigned parent or legal

guardian of the child shown above, have read the above and understood the foregoing assumption of

risk, and release of liability and agree to its terms on behalf of my child and myself. I understand that

by signing below, I am giving up substantial rights on behalf of my child and myself.​