TY HealthSpan Assumption of Risk, Release of Liability, and Hold Harmless Agreement
This page is provided for information. Document must be signed before service can be performed.
| DISCLOSURE AND ACKNOWLEDGMENT The undersigned (“You”) hereby enters into this Assumption of Risk, Release of Liability & Hold Harmless Agreement (this “Agreement”) for the benefit of TY Healthspan LLC, a Georgia limited liability company (“TY Healthspan”), and acknowledges the statements set forth in this paragraph. TY Healthspan, whose principals are Ravi Kahan and Fred Spring, provides health and physical testing, including VO2 Max, Sub Max, Dexa Scan, and Resting Metabolic Rate assessments, and health coaching to its customers for use by them in assessing aspects of their overall health, including in consultation with licensed medical professionals of their choosing. TY Healthspan does not employ or engage any physician or other medical professional, and consequently cannot and does not diagnose or treat any illness or other medical condition. TY Healthspan may lease, sublease, or license the use of office space to one or more licensed medical professionals who may independently provide medical services to You at your election, but such medical professionals are not employed, engaged as an independent contractor, or otherwise affiliated with TY Healthspan. TY Healthspan shall not be responsible or liable in any manner for the medical services or treatment provided by any such licensed medical professional to You. |
| ASSUMPTION OF RISKS |
| By participating in physical testing, including VO2 Max, Sub Max, or Resting Metabolic Rate assessments, by TY HealthSpan and using TY HealthSpan’s testing equipment (including the VO2 Master Analyzer or similar devices), You acknowledge that physical activity carries inherent risks. These risks may include, but are not limited to, cardiovascular events, respiratory complications, musculoskeletal injuries, or other health issues. |
| You understand that exercise intensity may gradually increase until fatigue, shortness of breath, dizziness, or discomfort occurs. You are responsible for monitoring your own condition during testing and must notify TY HealthSpan staff of any unusual symptoms. |
| You should consult a licensed medical professional before participation, especially if you have diabetes, obesity, respiratory or cardiovascular conditions, or any other pre-existing medical issues. Participation is voluntary, and you assume all associated risks. You hereby confirm that you do not have any injury or condition that could worsen due to participation. |
| If you experience skin irritation, difficulty breathing, or other medical concerns during or after using testing equipment, discontinue use immediately and notify TY HealthSpan staff. |
| RELEASE OF LIABILITY; COVENANT NOT TO SUE |
| In consideration of being permitted to participate in testing and health coaching by TY HealthSpan, you hereby waive, release, and discharge TY HealthSpan, its officers, directors, employees, managers, members, contractors, agents, affiliates, and representatives, and their successors and assigns (collectively, the “Released Parties”), from any and all claims, demands, or causes of action arising out of or related to your participation, including injuries, damages, or death, whether caused by negligence or otherwise. You further agree not to bring any lawsuit seeking any recovery or other recourse from or against TY Healthspan relating in any manner to your participation in testing by TY HealthSpan. |
| This release and covenant not to sue is intended to be as broad and inclusive as allowed under applicable law in the State of Georgia. If any part or provision of this Agreement is determined to be invalid, the remainder will remain in full force and effect. |
| HOLD HARMLESS |
| You agree to indemnify and hold harmless the Released Parties from any claims, damages, losses, costs, or expenses (including attorney fees and other legal expenses) arising from your participation in health coaching and testing or use of any testing equipment. |
| SCREENING QUESTIONS |
| Before beginning, please answer truthfully: |
| 1. Has a doctor advised you to limit physical activity due to a heart condition? ☐ Yes ☐ No |
| 2. Do you experience chest pain during activity? ☐ Yes ☐ No |
| 3. Have you experienced chest pain at rest in the past month? ☐ Yes ☐ No |
| 4. Do you have balance issues, dizziness, or fainting spells? ☐ Yes ☐ No |
| 5. Do you have bone, joint, or musculoskeletal problems that could be aggravated by exercise? ☐ Yes ☐ No |
| 6. Are you currently prescribed medication for heart or blood pressure issues? ☐ Yes ☐ No |
| 7. Any other reason you should not engage in physical activity? ☐ Yes ☐ No |
| If you answered “Yes” to any question, you must consult your physician before participating. |
| ACKNOWLEDGEMENT |
| By signing below, you confirm that you have read, understand, and agree to all statements and covenants above, including assumption of risk, release of liability, covenant not to sue, and hold harmless provisions, and are executing this Agreement intending to be legally bound. |
| Participant Name (Printed): ___________________________ |
| Participant Signature: ________________________________ |
| Date: __________________ |
| TY HealthSpan Staff Witness: __________________________ |
| Date: __________________ |