RELEASE OF LIABILITY AND ASSUMPTION OF RISKS


 

 

RELEASE OF LIABILITY AND ASSUMPTION OF RISKS

THIS RELEASE IS A BINDING LEGAL CONTRACT.
PLEASE READ IT CAREFULLY BEFORE SIGNING.

 

 

I acknowledge that I have been advised about the program that I am going to participate in with my Jake Zemer, LLC trainer either by myself, or with a minor child or children under my supervision (AService@).

I understand that any Service I/we receive is provided for educational purposes. If I, or any child under my supervision experience any pain or discomfort, I/we will immediately cease my/our participation. No Service should be construed as a substitute for medical examination, diagnosis or treatment, and I understand that I should see a physician or other qualified medical professional for any medical or physical ailment or condition. I understand that Jake Zemer, LLC and its trainers, are not necessarily qualified to perform, diagnose, prescribe, or treat any physical or mental ailment or condition and that nothing said by Jake Zemer LLC and its trainers, in the course of or before or after the session should be construed as medical advice.


I also acknowledge and certify that the following statements are true:

1. Because Services should not be performed under certain medical conditions, I hereby certify that neither I nor any minor child under my supervision currently has any medical condition that restricts my or their ability to receive the Services;
2. I have discussed the Services with my/our physicians or other qualified professionals and have been advised by him/her/them that I and any minor children under my supervision may safely receive the Services; and
3. I have read the rules and regulations and understand that I and any person participating under my supervision must adhere to them. I also agree that I am solely responsible for the supervision of any person or persons who is participating in the Services with me.


I am also aware that photographic and video equipment may be in use in Jake Zemer, LLC’s studios And common areas. As such my image, and that of any minor child under my supervision, may be captured by such equipment. I hereby consent and release to Jake Zemer, LLC the right to capture and incidentally use such images in its advertising or promotions as well as my name and image for testimonial purposes without remuneration or compensation.

On behalf of myself and any person participating under my supervision, I expressly and voluntarily waive and release Jake Zeme, LLC and its trainers from any and all liability for any claims, demands, or actions of any kind, including, but not limited to, personal injury or property damage that may occur in the course of any Service, or arising out of the use of the premises provided. I further agree to defend, indemnify and hold harmless Jake Zemer, LLC and its trainers from any and all claims, actions or demands by any other party or individual which may arise out of any Services provided.

I acknowledge that I have read and understand the contents of this waiver and release.

 

MONTHLY SUBSCRIPTIONS & CANCELLATION POLICY

 

Subscriptions for executive coaching services are renewed each month and are billed to a credit card of your choice. Our cancellation policy requires a minimum of seventy-two hours’ written notice by email or text prior to your regular monthly renewal date. A cancellation with less than seventy-two hours’ written notice will not be honored.

 

Date: March 26, 2025

Printed Name:    

Email Address:  

Phone Number:  

 

Credit Card Authorization Form

I,     authorize JAKE ZEMER LLC to charge my credti card for the amounts that are stipulated in the current and future agreement between     and JAKE ZEMER LLC.

Name on Credit Card    
Billing Address 
Credit Card Number 
Expiration Date 
Security Code 
Date  March 26, 2025

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Signature Certificate
Document name: RELEASE OF LIABILITY AND ASSUMPTION OF RISKS
lock iconUnique Document ID: ace0f5dddbac09fc680dd7ea9807c4d22f74da3f
Timestamp Audit
December 4, 2024 12:57 am EDTRELEASE OF LIABILITY AND ASSUMPTION OF RISKS Uploaded by Jacob Zemer - jacob@jacobzemer.com IP 171.48.107.19
December 5, 2024 6:41 am EDTContract Signed - i1ckuyynubf2rre7oscbk489x74gruim@hook.us1.make.com added by Jacob Zemer - jacob@jacobzemer.com as a CC'd Recipient Ip: 106.221.153.1
December 19, 2024 4:20 am EDTContract Signed - i1ckuyynubf2rre7oscbk489x74gruim@hook.us1.make.com added by Jacob Zemer - jacob@jacobzemer.com as a CC'd Recipient Ip: 171.48.107.19