INFORMED CONSENT WAIVER, RELEASE OF LIABILITY AND PERMISSION FOR PHOTOGRAPHY

In consideration of being allowed to participate in any NeuroAthlete athletic training or NeuralTraining program, related events and activities, I intend to be legally bound and do hereby agree to be legally bound for myself and for all successors in interest I may have, by this Contract, and hereby agree to hold harmless and indemnify Springs Soft Tissue, LLC, NeuroAthlete, LLC and NeuroAthlete Clinic (“Principals”) as well as all officers, members, employees, assistants, volunteers, assigns, or agents of any type whatsoever acting on or in behalf of the aforementioned entities and persons (including Peter Hoversten, Grove Higgins, Pat Marques and Mary Wilson), against any claims for damages or other claims for injuries or losses of any kind suffered by me or any others, directly or indirectly, arising out of any practice, instructions, or other activity related to this program as well as participation in this program or traveling to or from this program or any other activity related to this program.

I understand that the activities, exercises and training methods to be taught may not be appropriate for all people and may, in some cases, cause injury or aggravate existing injuries. I certify that I am physically able to participate in this activity and will further hold Principals as well as any and all officers, members, employees, assistants, volunteers, assigns, or agents of any type whatsoever acting on or in behalf of the aforementioned entities and persons (including Peter Hoversten, Grove Higgins, Pat Marques) and Mary Wilson, harmless for any injury sustained in the course of this training due to any physical defect or condition that I may have, whether now known or hereinafter discovered. I further acknowledge that in consideration for this training, this release shall not expire and shall be considered effective in perpetuity. I also understand that all exercises, training methods and concepts are to be used at my own risk and that the aforementioned trainers and entities assume no responsibility for my actions.

I acknowledge that if I am uncomfortable with any activity, exercise or training program within the course or if I observe any unusual significant hazard during my presence or participation that I may immediately state so, and that it is my right and responsibility to remove myself from the situation immediately and that I am encouraged to do so.

I grant to Principals the absolute and irrevocable right and unrestricted permission concerning any photographs or video (“Content”) that Principals have taken or caused to be taken or may take or cause to be taken of me or in which I may be included with others, to use, reuse, publish, and republish the Content in whole or in part, individually or in connection with other material, in any and all media now or hereafter known, including the internet, and for any purpose whatsoever, specifically including illustration, promotion, art, education, editorial, advertising, and trade, without restriction as to alteration; and to use my name in connection with any use if Company so chooses. I release and discharge Principals from any and all claims and demands that may arise out of or in connection with the use of the Content, including without limitation any and all claims for libel or violation of any right of publicity or privacy. This authorization and release shall also inure to the benefit of legal representatives, licensees, and assigns of Principals.

I have read this document and fully understand its contents. Additionally, I certify that I am eighteen years of age or older, or a legally emancipated adult. I certify that I am of sound judgment, legally competent to agree to this waiver.