Informed Consent and Liability Waiver

Release for Participation in City of Los Angeles LA Well Program

I am voluntarily participating in the virtual live exercise/fitness program (“Program”) offered by Anthem Blue Cross through Strive Well-Being, Inc. (collectively “Host”), as part of the City of Los Angeles LA Well Program.  I recognize that my participation in the Program is completely voluntary and not a requirement nor a part of my employment with the City of Los Angeles.  I also recognize that the Host of the Program is not an employee of the City of Los Angeles.

I understand that participation in the Program will require physical exertion that may be strenuous at times and may cause physical injury and I am fully aware of the risks and hazards involved.  I represent and warrant that to my knowledge, I have no medical condition that would prevent my participation in the Program.  I am making the informed judgment that I am capable of participating in the program without suffering adverse effects upon my health.

I agree to assume full responsibility for any risks, injuries or damage known or unknown which I might suffer as a result of participating in the Program.  Such injuries may include, but are not limited to, heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration, injuries to knees, injuries to back, injuries to foot, or any other illness or soreness, regardless of severity. 

I understand that the Program will be offered through ZOOM, an online video conferencing service, and its use may reduce the bandwidth available at my location which may impact the functionality of other devices which require bandwidth for internet access.  I understand that in using ZOOM, I may inadvertently view settings and surroundings of which the Host and the City of Los Angeles cannot control or enable me to control.  I further understand that in using ZOOM, my name, telephone number, or other identifying information will be disclosed to the Host and others, whether known or unknown, who are participating or accessing the Program.

I also understand that my use of ZOOM may also result in the intentional or unintentional audio and video recordings of me by ZOOM, the Host, and others, whether known or unknown, who are participating or accessing the Program.  I therefore hereby consent to the photographing or recording in any manner of my voice and likeness in connection with the use of ZOOM.

I further knowingly, voluntarily, and expressly waive any claim, of any nature and arising from any cause whatsoever, that I have or may have in the future against the City of Los Angeles for any injury or damage whether physical or emotional, that I may sustain as a result of participating in the Program through ZOOM. 

I have read the above waiver and release of liability and fully understand it contents. I voluntarily agree to the terms and conditions stated above.