I, being of lawful age, for myself, my minor child and all family members hereby fully and forever release, acquit and discharge Starz Track Club, its present and former employees, agents, sponsors, subsidiaries and volunteers (herein after “Starz Track Club”) from any and all actions, causes of action, claims and demands of whatsoever kind or nature on account of any and all injuries, losses and damages to us or to our property sustained or received through participation in or attendance at Starz Track Club  activities.  I acknowledge that Starz Track Club has taken all necessary and reasonable precautions to make the environment safe for its participants and visitors.  I acknowledge further that Starz Track Club may, as necessary, administer medical treatment to me or to my minor child (as the case may be) to the extent of their medical training. I waive all rights to hold Starz Track Club liable for any related medical conditions caused by such participation or medical treatment performed in good faith.  I hereby declare that I fully understand the terms of this waiver and that I voluntarily accept the terms contained herein.  I further agree not to make any claim or to take any proceedings against any other person or corporation who or which might claim contribution or indemnity from Starz Track Club.

Name of Participant:               ______________________________

Signature:                               ______________________________

Date:                                       ______________________________

Witness:                                  ______________________________

Relationship to participant:     ______________________________