Risk Acknowledgment: I understand that participating in activities and using facilities at Village Fitness and Physical Therapy, Inc. (“Village”) involves inherent risks such as bodily injury, illness, or potentially death. These risks may arise from various causes including but not limited to negligence of Village staff or other participants. I voluntarily assume all these risks by engaging in Village activities or using its facilities and equipment.

Release of Liability: I hereby release and hold harmless Village, its employees, and representatives from any claims of injury, property damage, or wrongful death, whether caused by negligence or any other reason, arising from my participation in Village activities or use of Village facilities. This waiver applies to me, my heirs, and my personal representatives.

Payment and Insurance Disclosure: Payment is due at the time of service and Village does not bill insurance directly. Village is a non-participating Medicare provider and does not submit claims for Medicare-covered services. All services provided are considered non-covered under Medicare and other insurance plans. Receipts are available upon request but may not meet the documentation standards required for insurance claims.