First Name

Last Name

Phone *

Email *

Address *

City *

State *

Postal code *

Date of birth *

Gender *

Ethnicity *

Service-Connected Disability *

Yes

n/a

Employment Status *

Veteran Era *

Military Type *

Eligibility Type *

Professional Athlete

Veteran

Active Duty

Military Service Branch *

Military Status *

Professional Sport (answer only required for pro athletes)

How would you rate your overall mental health? *

Have you experienced any recent significant life changes or stressors? (e.g, job loss, divorce, relocation) *

How would you rate your overall physical health? *

Do you currently have a strong sense of purpose or direction in life? *

How often do you engage in physical activity or exercise per week? *

How comfortable are you in seeking emotional support from others (e.g., talking about your feelings, wins, loses, challenges)? *

How would you describe your level of social support (e.g., friends, family, community)? *

How connected do you feel to your community and social groups? *

What activities or initiatives do you like to enhance your sense of belonging? *

Is there are any other information you would like to us to know about you ? *

What are you goals or expectations in joining as a participant with our nonprofit? *

How did you hear about us? *

PARTICIPANT AGREEMENT

The individual named below (referred to as “I” or “me”) desires to participate in accepted training and therapeutic activities (whether singular or plural, hereinafter referred to as the “Activities”), provided by Merging Vets & Players, a Nevada non-profit corporation (the “Company”). As lawful consideration for being permitted by the Company to participate in the Activities, I agree to all the terms and conditions set forth in this agreement (this “Agreement”).

I AM AWARE AND UNDERSTAND THAT THE ACTIVITIES ARE HAZARDOUS AND INVOLVE RISK OF SERIOUS INJURY, CONTRACTION OF ILLNESS OR MEDICAL CONDITION, DEATH AND/OR PROPERTY DAMAGE. I ACKNOWLEDGE THAT ANY INJURIES THAT I SUSTAIN MAY BE COMPOUNDED BY NEGLIGENT EMERGENCY RESPONSE OR RESCUE OPERATIONS OF THE COMPANY. I ACKNOWELDGE THAT I AM KNOWINGLY AND VOLUNTARILY PARTICIPATING IN THE ACTIVITIES WITH AN EXPRESS UNDERSTANDING OF THE DANGER INVOLVED AND HEREBY AGREE TO ACCEPT AND ASSUME ANY AND ALL RISKS OF INJURY, DEATH, OR PROPERTY DAMAGE, WHETHER CAUSED BY THE ORDINARY NEGLIGENCE OF THE COMPANY, MY PARTICIPATION OR OTHERWISE.

I hereby expressly waive and release any and all claims which I may have, or which I may hereafter have, whether known or unknown, against the Company, and its officers, employees, agents, affiliates, successors, and assigns (collectively, the “Releasees”), on account of injury, death, or property damage arising out of or attributable to my participation in the Activities, whether arising out of the ordinary negligence of the Company or any Releasees or otherwise. I covenant not to make or bring a claim against the Company or any other Releasee, and forever release and discharge the Company and all other Releasees from liability under such claims. This waiver does not extend to claims for gross negligence, intentional or reckless misconduct, or any other liabilities that Nevada law does not permit to be released by agreement.

This waiver and release of all liability includes, without limitation, injuries which may occur as a result of (a) my use of any facility or its improper maintenance, (b) my use of any equipment which may malfunction or break, (c) the Company’s or any partner gym’s improper maintenance of any exercise equipment, (d) the Company’s or any partner gym’s negligent instruction or supervision, (e) the Company’s or any partner gym’s negligent hiring or negligent retention of any employee, and (f) my slipping and falling while in the center or on the surrounding premises.

I understand that by signing this release, I am waiving any and all claims of any kind arising out of or attributable to my participation in the Activities, including those claims that may be unknown to me, or which I do not suspect to exist at this time. WITH THE INTENTION OF WAIVING ALL UNKNOWN AND UNSUSPECTED CLAIMS, I HEREBY EXPRESSLY WAIVE ALL RIGHTS, BENEFITS, AND PROTECTIONS I MAY HAVE UNDER NEVADA CIVIL CODE SECTION 1542, WHICH READS AS FOLLOWS:

A general release does not extend to claims that a creditor or releasing party does not know or suspect to exist in his or her favor at the time of executing the release and that, if known by him or her, would have materially affected his or her settlement with the debtor or released party.

I shall defend, indemnify, and hold harmless the Company and all other Releasees against any and all losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including attorney fees, fees and the costs of enforcing any right to indemnification under this Agreement, and the cost of pursuing any insurance providers arising out of or resulting from any claim of a third party related to my participation in the Activities, including any claims arising out of my own negligence or the ordinary negligence of the Company.

This Agreement constitutes the sole and entire agreement of the Company and me with respect to the subject matter contained herein and supersedes all prior and contemporaneous understandings, agreements, representations, and warranties, both written and oral, with respect to such subject matter. If any term or provision of this Agreement is held invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability shall not affect any other term or provision of this Agreement or invalidate or render unenforceable such term or provision in any other jurisdiction. This Agreement is binding on and shall inure to the benefit of the Company and me and their respective heirs, successors, and assigns. All matters arising out of or relating to this Agreement shall be governed by and construed in accordance with the internal laws of the State of Nevada without giving effect to any choice or conflict of law provision or rule (whether of the State of Nevada or any other jurisdiction). Any claim or cause of action arising under this Agreement may be brought only in the federal and state courts located in State Court of Clark County, West District and I hereby consent to the exclusive jurisdiction of such courts.

BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND FULLY UNDERSTOOD ALL OF THE TERMS OF THIS AGREEMENT AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE THE COMPANY FOR CLAIMS, WHETHER KNOWN OR UNKNOWN, ARISING OUT OF MY PARTICIPATION IN THE ACTIVITIES.

PARTICIPANT STANDARD OF CONDUCT POLICY

The individual named below (referred to as “I” or “me”) desires to participate in a program involving training and therapeutic activities (whether singular or plural, hereinafter referred to as the “Activities”) provided by Merging Vets & Players, a Nevada non-profit corporation (the “Company”). As lawful consideration for being permitted by the Company to participate in the Activities, I agree to all the terms and conditions set forth in this Standard of Conduct Policy (this “Policy”).

All Unlawful Harassment Prohibited

The Company is committed to providing a workplace that is free from unlawful harassment. The Company strictly prohibits and does not tolerate unlawful harassment against employees, covered persons (i.e., interns, volunteers, applicants or independent contractors) and participants, by co-workers, supervisors, managers, participants or third parties on the basis of a person’s race; religious creed, including religious belief, observance and practice, and dress or grooming practices; color; national origin; ancestry; physical disability; mental disability; medical condition, including any cancer-related physical or mental health impairment from a diagnosis, record or history of cancer, or a genetic characteristic; genetic information, including information about an individual’s genetic tests, family members’ genetic tests, family members’ diseases or disorders, an individual’s or family member’s receipt of, or request for, genetic services, and participation by an individual or their family member in clinical research that includes genetic services; marital status; sex, including pregnancy, childbirth, or medical condition related to pregnancy, childbirth, or breast feeding; gender; gender identity, meaning a person’s identification as male, female, a gender different from the person’s sex at birth, or transgender; gender expression, meaning a person’s gender-related appearance or behavior, whether or not stereotypically associated with the person’s sex at birth; age (40 or older); sexual orientation, including: heterosexuality, homosexuality, and bisexuality; military and veteran status, or any other characteristic protected under applicable federal, state or local law.

The Company also prohibits and does not tolerate unlawful harassment against employees, covered persons and participants who are perceived to have any of these characteristics or who associate with a person who has, or is perceived to have, any of these characteristics. Harassment can occur in the locations in which the Company operates or on social media. It should always be reported and will not be tolerated by the Company.

Sexual Harassment

All Company employees, partner gym employees and participants are prohibited from harassing employees and other covered persons based on that individual’s sex (including that individual’s pregnancy, childbirth, breastfeeding, or medical conditions relating to pregnancy, childbirth or breastfeeding), sexual orientation or gender (including that individual’s gender identity and gender expression) and regardless of the harasser’s sex or gender. Sexual harassment is illegal and also against the Company’s Policy.

Sexual harassment means any harassment based on someone’s sex, sexual orientation or gender, as described in this Policy. It includes harassment that is not sexual in nature (e.g., offensive remarks about an individual’s sex or gender), as well as any unwelcome sexual advances or requests for sexual favors or any other conduct of a sexual nature, when any of the following is true: submission to the advance, request or conduct is made either explicitly or implicitly a term or condition of employment or participation; submission to or rejection of the advance, request or conduct is used as a basis for employment decisions or participation; such advances, requests or conduct have the purpose or effect of substantially or unreasonably interfering with an employee’s or participant’s work performance by creating an intimidating, hostile or offensive work environment; the Company will not tolerate any form of sexual harassment, regardless of whether it is verbal (e.g., epithets, derogatory statements, slurs, sexually-related comments or jokes, suggestive or obscene letters, unwelcome sexual advances or requests for sexual favors); physical (e.g., assault, inappropriate physical contact or impeding or blocking movements); visual (e.g., displaying sexually suggestive posters cartoons or drawings, sending inappropriate adult-themed gifts, leering or making sexual gestures); retaliatory (e.g., threatening retaliation or taking retaliatory action).

This list is illustrative only, and not exhaustive. No form of sexual harassment will be tolerated. Harassment is prohibited at all locations in which the Company operates, including partner gyms, and on social media.

Other Types of Harassment

The Company’s anti-harassment policy applies equally to other unlawful harassment based on an employee’s race, color, religious creed, religious belief, observance or practice, national origin, ancestry, age (40 and over), marital status, genetic information, medical condition, mental disability, physical disability, or military or veteran status (as described earlier in this Policy), as well as any other characteristic protected under applicable federal, state or local law.

Such harassment often takes a similar form to sexual harassment and includes harassment that is verbal (e.g., epithets, derogatory statements, slurs, derogatory comments or jokes); physical (e.g., assault or inappropriate physical contact); visual (e.g., displaying derogatory posters, cartoons, drawings or making derogatory gestures); retaliatory (e.g., threatening retaliation or taking retaliatory action).

No Retaliation

No one will be subject to, and the Company prohibits, any form of discipline, reprisal, intimidation or retaliation for good faith reporting of incidents of harassment of any kind, pursuing any harassment claim or cooperating in related investigations.

Violations of this Policy

Any employee or participant whom the Company determines has subjected an individual to harassment or retaliation in violation of this Policy, will be subject to discipline, up to and including termination of employment or participation.

Administration of this Policy

The Executive Management Team is responsible for the administration of this Policy. If you have any questions regarding this policy or questions about harassment that are not addressed in this Policy, please contact [email protected]

I acknowledge that I received and read a copy of the Company’s Participant Agreement/Standard of Conduct and understand that it is my responsibility to be familiar with and abide by its terms.

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