The Wellness Boutique

Liability Release and Indemnity. For good and valuable consideration (including being permitted to receive the Services), the receipt and sufficiency of which are hereby acknowledged, I agree to release and hold harmless, and covenant not to sue, the Company, the facility on whose premises my
services and training will occur (the “Location”), the respective directors, managers, instructors, officers, representatives, members, stockholders, partners, agents and employees of the Company and the Location, and each of their respective affiliates (hereinafter collectively “The Wellness Boutique”) from any and all liability, whether based on negligence, contract, tort, statute or otherwise, for any claim (including third party claims) judgment, loss, liability, cost and expenses (including, without limitations, attorney’s fees and costs) arising out of or connected in any way with any and all memberships, services, training, products, diets, or other interaction I have with the Company or any Releasee (the “Services”), including but not limited to any claim arising out of or connected in any way with (i) any illness or injury (minimal, serious, catastrophic and / or death) that I may incur or sustain during or that may in any way arise in connection with the Services (whether or not at the Location and whether or not relating to any new or pre-existing condition, disclosed or undisclosed), (ii) any complications in my pregnancy or effect on my child (before or after birth) that I may incur or sustain during or that may in any way arise in connection with the Services (whether or not at the Location and whether or not relating to any new or preexisting condition, disclosed or undisclosed), (iii) any act or omission of any kind or character (whether negligent, grossly negligent, tortious or otherwise) of any employee, consultant, other independent contractor or other representative of the Company (whether at the Location, in connection with the Services, or otherwise) and (iv) any and all activities associated or connected in any way with the Services and while traveling to and from the Location, in each of the foregoing cases whether or not the Services are actually rendered in full or in part. I further expressly agree to indemnify and hold harmless The Wellness Boutique and The Wellness Boutique’ heirs, successors, assigns, executors and administrators against loss from any claims, demands or actions that may subsequently be brought by me or by any other persons on the account of damages, costs, expenses, liabilities or other losses of any character resulting to me in any way from, in connection with, or as a consequence of, any and all activities associated or connected in any way with the Services and while traveling to and from the Location, in each of the foregoing cases whether or not the Services are actually rendered in full or in part. I further agree to reimburse and to make good to The Wellness Boutique any loss, damages, or costs The Wellnesss Boutique may have to pay as a result of any such action, claim, or demand, including but not limited to attorneys’ fees. I understand that the foregoing waivers and indemnities are a material inducement to the Company to allow
me to receive the Services, that the Company is expressly relying on such waivers and indemnities in allowing me to receive the Services, and that but for such waivers and indemnities I would not be permitted to receive the Services.

Medical Release: I acknowledge and agree that receiving the Services subjects me to the risk of physical illness or injury (minimal, serious, catastrophic and / or death) and that I acknowledge that I am assuming the entire risk of such illness or injury by receiving the Services. In the event of such illness or injury, I authorize the Company to obtain necessary medical treatment for me and hereby release and hold harmless The Wellness Boutique in the exercise of this authority. I further acknowledge and understand that I will be responsible for any and all medical and related bills that may be incurred by me for any illness or injury that I may sustain in connection with the Services and while traveling to and from the site for the Services whether or not the Services are actually rendered.

Governing Law: Consent To Jurisdiction And Service Of Process; WAIVER OF JURY TRIAL. This Agreement shall be governed by, and construed
and enforced in accordance with, the laws of the State of New York, without regard to its conflicts of laws rules. I hereby submit to the exclusive
jurisdiction of the federal and state courts in the City, State and County of New York with respect to any dispute, controversy, action, suit or proceeding of
any kind relating to (i) the performance, interpretation or enforcement of the provisions of this Client Enrollment Form, (ii) the provision of any and all
Services, and (iii) any other agreement, instrument and other document entered into in connection herewith or therewith (each, an “Action”) and hereby waive, and agree not to assert, as a defense in any such Action, that (a) such Action is not subject to such jurisdiction, (b) that such Action may not be
brought or is not maintainable in such courts, (c) that this Agreement or any such other agreement, instrument or other document may not be enforced in
or by such courts, (d) that my property is exempt or immune from execution, (e) that such Action is brought in an inconvenient forum, (f) that the venue of
such Action is improper, or (g) that New York substantive law should not apply. Service of process with respect thereto may be made upon me by mailing a copy thereof by registered or certified mail, postage prepaid, or overnight courier to me to the address set forth above; provided that service of process may also be accomplished in any other manner permitted by applicable law. I HEREBY WAIVE MY RIGHT TO A JURY TRIAL OF ANY CLAIM OR CAUSE OF ACTION BASED UPON OR ARISING OUT OF THIS CLIENT ENROLLMENT FORM OR THE PROVISION OF ANY SERVICES. I ALSO WAIVE ANY BOND OR SURETY OR SECURITY UPON SUCH BOND WHICH MIGHT, BUT FOR THIS WAIVER, BE REQUIRED IN ANY CONTEXT. THE SCOPE OF THIS WAIVER IS INTENDED TO BE ALL-ENCOMPASSING OF ANY AND ALL DISPUTES THAT MAY BE FILED IN ANY COURT AND THAT RELATE TO THE SUBJECT MATTER OF THIS CLIENT ENROLLMENT FORM OR THE SERVICES, INCLUDING, WITHOUT LIMITATION, CONTRACT CLAIMS, TORT CLAIMS, BREACH OF DUTY CLAIMS AND ALL OTHER COMMON LAW AND STATUTORY CLAIMS. I FURTHER REPRESENT THAT I HAVE REVIEWED THIS WAIVER, THAT I HAVE BEEN ADVISED TO CONSULT WITH LEGAL COUNSEL, AND THAT I HAVE KNOWINGLY AND VOLUNTARILY WAIVED MY JURY TRIAL AND OTHER RIGHTS OR DEFENSES SET FORTH HEREIN. THIS WAIVER IS IRREVOCABLE, MEANING THAT IT MAY NOT BE MODIFIED EITHER ORALLY OR IN WRITING, AND THE WAIVER SHALL APPLY TO ANY SUBSEQUENT AMENDMENT, RENEWAL, SUPPLEMENT OR MODIFICATION OF OR TO THIS CLIENT ENROLLMENT FORM. IN THE EVENT OF LITIGATION, THIS CLIENT ENROLLMENT FORM MAY BE FILED AS A WRITTEN CONSENT TO A TRIAL BY THE COURT.

Entire Agreement: This Client Enrollment Form (including all attachments hereto, which are made a part hereof) contains the entire understanding of the parties hereto with respect to the subject matter hereof and supersedes all prior agreements and understandings relating to the subject matter hereof. If
you elect any Membership, you are (in addition to each of your agreements contained herein) agreeing to be bound by the Membership Terms attached hereto and which are made a part hereof. If you elect Private Training or Semi-Private Training, you are (in addition to each of your agreements contained herein) agreeing to be bound by both the Membership Terms and the Private and Semi-Private Training Terms attached hereto and which are made a part hereof.

I hereby represent and warrant that I have read this Client Enrollment Form in its entirety and fully understand its contents. I am aware that this Client Enrollment Form releases The Wellness Boutique from liability and contains an acknowledgement of my voluntary and knowing assumption of the risk of injury or illness. I further acknowledge that nothing in this Client Enrollment Form constitutes a guarantee that the Services will be fully or partially rendered. I have signed this document voluntarily and of my own free will.