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
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
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
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.