14309 N. Santa Fe Ave., Edmond, OK 73013 | (405) 500-1838

THIS IS A RELEASE OF LIABILITY.  BY SIGNING THIS DOCUMENT, YOU ARE ASSUMING RISK AND RELEASING BLACK WALL POWERLIFTING LLC dba BLACK WALL STRENGTH AND ALL OTHER RELATED PARTIES FROM LIABILITY.  PLEASE READ AND REVIEW THESE PROVISIONS CAREFULLY.

I, (“I” or “me”) desire to access and utilize the facility and equipment, classes, training, and other related services (the "Services") provided by Black Wall Powerlifting LLC, an Oklahoma limited liability company dba Black Wall Strength (“BWS”).  As lawful consideration for being permitted by BWS to access the facility and participate in the Services, I agree to all the terms and conditions set forth in this release (this "Release").

I am aware and understand that the Services are dangerous, involve the risk of serious injury and/or death and/or property damage, and I agree to follow all instructions so that I may safely participate in the Services.  I acknowledge that I am voluntarily participating in the Services with the knowledge of the danger involved and hereby agree to accept and assume any and all risks of injury, death, or property damage, whether caused by the negligence of BWS or otherwise.  I hereby consent to and permit any emergency treatment in the event of injury or illness.  I represent and warrant that I am in good physical health and do not suffer from any medical condition which would limit my participation in the Services offered and made possible by BWS.  I understand that it is my responsibility to consult with a physician prior to, and regarding my, participation in any of the Services, the classes and training offered.  I acknowledge and agree that if I am under the influence of alcohol I will not engage in the Services. I fully understand that contagious and communicable diseases carry inherent risk of exposure wherever people are present and no precautions, including the health and safety protocols can eliminate the risk of exposure and potential illness, disability, other short-term and long-term health effects, and/or death.  I hereby confirm that I have no physical or emotional health problems incompatible with the Services.

I hereby expressly waive and release any and all claims, now known or hereafter known, against BWS, and its officers, directors, employees, agents, affiliates, successors, and assigns (collectively, with BWS, the "Released Parties"), on account of injury or disease, death, or property damage arising out of or attributable to my presence at the facility or my participation in the Services, whether arising out of the negligence of the Released Parties or otherwise.  I covenant not to make or bring any such claim against the Released Parties, and forever release and discharge the Released Parties from liability under such claims.  I shall defend, indemnify, and hold harmless the Released Parties against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including attorney fees, fees and the costs of enforcing any right to indemnification under this Release, and the cost of pursuing any insurance providers arising out of or resulting from any claim of a third party related to the Services.

I hereby irrevocably authorize and license the Released Parties the right to use, display, publicly perform, exhibit, transmit, broadcast, reproduce, record, photograph, digitize, modify, alter, edit, adapt, create derivative works, and exploit my name, image, likeness, appearance, and voice in all materials created by or on behalf of the Released Parties that incorporate any of the foregoing (collectively "Materials") all of which are owned solely by the Released Parties, on a perpetual basis throughout the world and in any medium or format whatsoever now existing or hereafter created and for any purpose, including but not limited to, advertising, public relations, licensing, publicity, packaging, and promotion of the Released Parties and their affiliates and their businesses, products, and services, without further consent from or royalty, payment, or other compensation to me.  I hereby irrevocably release and discharge the Released Parties from any and all claims I might have, including those for copyright or trademark infringement, infringement of moral rights, defamation, invasion of rights of privacy or rights of publicity, false light, physical or emotional injury or distress, or any similar claim or cause of action in tort, contract, or any other legal theory, now known or hereafter known in any jurisdiction throughout the world arising directly or indirectly from the exercise by the Released Parties of their rights hereunder and the use and exploitation of the Materials.

All matters arising out of or relating to this Release shall be governed by and construed in accordance with the internal laws of the State of Oklahoma without giving effect to any choice or conflict of law provision or rule (whether of the State of Oklahoma or any other jurisdiction).  Any claim or cause of action arising under this Release may be brought only in the federal and state courts located in Oklahoma County, Oklahoma and I hereby consent to the exclusive jurisdiction of such courts.

I am the parent or legal guardian of the individual named above, and I hereby sign this Release of Liability and Assumption of Risk on behalf of such individual in accordance with the statements above.  I understand and agree to its provisions, consent to the emergency medical treatment and will be responsible for any and all costs.  I have discussed with the participant the requirements to follow all instructions, observe rules and to act in a safe and prudent manner.  I concur with representations made by the participant about physical capabilities and working order of equipment, and agree BWS may use his/her name, image, likeness, appearance, and voice.