Exhibit C
Informed Consent and Liability Waiver Release for Participation in Exercise
Program
1. I am above the age of eighteen (18) years, and I am voluntarily participating in an exercise
program offered by Union Three. In consideration of joining in the classes,
activities, or other programs, and using the premises, facilities, and/or equipment, at the venue where
[Water Street Tampa] is providing services (the “Activity”), I agree and acknowledge that I am fully
aware that there are significant inherent risks and dangers involved in physical activities, including the
potential of death, injury, and/or property damage. I further agree and acknowledge that I am
voluntarily participating in the Activity during the time period of the spread of the infectious disease
otherwise known as COVID-19, and I am fully aware that the very nature of said Activity may place
me at higher risk for contracting the disease. I accept all the risks of participating, even if the risks are
created by the carelessness, negligence or gross negligence of a Released Party (as defined below) or
anyone else.
2. “Claims” includes but is not limited to any and all liabilities, claims, demands, legal actions,
rights of actions for damages, costs, procedures, personal injury or death (including, without
limitation, personal injury or death sustained as a result of being exposed to or otherwise becoming
infected with COVID-19 or a COVID-19 related illness) in connection with participation in the
Activity. “Released Party” means [_______________________________] and its affiliates, CBP
Development LLC, CBP Development Management LLC, Franklin Street Management Services
LLC, Water Street Tampa, LLC, WST 1045 Cumberland LLC, WST 1077 Water Street LLC, Tampa
Port Authority d/b/a Port Tampa Bay, and Strategic Property Partners LLC, and all of their affiliates,
and their respective representatives, directors, officers, agents, employees and volunteer staff.
3. I agree and acknowledge that: (a) I am in proper physical condition to participate in the
Activity, and am aware that participation could, in some circumstances, result in physical injury,
serious physical injury or death; (b) I understand my physical limitations and am sufficiently
self-aware to stop physical activity before I become ill or injured; (c) if, in the subjective opinion of
any Released Party, I would be at risk by participating in the Activity, I may be denied access to the
Activity (d) at all times I shall comply with all stated and customary terms, sanitation, disinfectant and
cleaning measures, social distancing, posted safety signs, rules, and verbal instructions given to me by
any Released Party; and (e) I am aware that if the Activity occurs outdoors, the streets adjourning the
area of the Activity are open to regular vehicular traffic during the Activity and I will obey all traffic
laws and regulations.
4. I hereby, for myself and for my heirs, next of kin, executors, administrators and assigns,
fully release, waive and forever discharge any and all rights or Claims I may have, now or in the
future, against any Released Party, even if the Claims are based on the carelessness, negligence or
gross negligence of a Released Party or anyone else. Without limiting the foregoing, I further
release any recourses which I may now or hereafter have resulting from any decision of any
Released Party.
5. I agree not to sue any Released Party for Claims, even if the Claims arise from the
carelessness, negligence or gross negligence of any Released Party or anyone else. I agree to
indemnify (reimbursement
for any loss) and hold harmless each Released Party from any loss or liability (including any reasonable
legal fees they may incur) defending any Claim made by me or anyone making a Claim on my behalf,
even if the Claim is alleged to or did result from the carelessness or negligence of any Released Party or
anyone else.
6. I am aware that it is advisable to consult a physician prior to participating in the Activity. I:
(a) have no physical or medical condition which would prevent me from properly and safely
participating in the Activity to include, without limitation, fever/chills, shortness of breath, loss of
taste or smell, muscle pains, dry cough, sore throat, or diagnosis of COVID-19 or exposure to
someone with COVID-19 within the 14 days immediately preceding the Activity; (b) have not been
instructed by a physician to avoid physical activity and/or exercise; and (c) if I have consulted a
physician, I have taken my physician’s advice.
7. I am aware that there is no obligation for any person to provide me with medical care during
the Activity. I understand and acknowledge that: (a) there may be no aid stations available for the
Activity; and (b) If medical care is rendered to me, I consent to that care if I am unable to give my
consent for any reason at the time the care is rendered.
8. I grant my permission to the Released Party and any transferee or licensee or any of them, to
utilize any photographs, motion pictures, videotapes, recordings and other references or records of the
Activity which may depict, record or refer to me for any purpose (“Images”), including commercial use
by the released parties, their sponsors and their licensees. This permission is for use anywhere in the
world and on the Internet and for an unlimited period of time. I understand and agree that I will not be
compensated or receive additional consideration for consenting to the use of the Images and that I will
not be given a chance to receive, inspect or approve the promotional or marketing material, messages
and/or content that may use the Images. I hereby release the Released Party including, without
limitation, all persons who took or otherwise created, recorded or modified the Images, from any and
all claims, actions, damages, interest, costs, expense and compensation of whatsoever kind and
howsoever arising, whether known or unknown, and which I now have or at any time hereafter can,
shall or may have in connection with, or in any way resulting or arising from, the Images and the
creation, use or disposition of them.
9. I acknowledge and agree that the Released Party shall own all right, title and interest,
throughout the world, in and to the Images and any materials compromising all or any part of the
Images, and that the Released Party has the unrestricted right to use, license, sell, transfer or otherwise
dispose of any or all of them, as well as the Released Party’s rights under this Release and Waiver, in
any manner whatsoever and without any accountability to me. I hereby assign to the Released Party all
right, title and interest, throughout the world, I may have in and to the Images and any materials
comprising all or any part of the Images, including all intellectual property rights thereto. I hereby
irrevocably waive any and all of my moral rights and any other irrevocable rights I may have,
throughout the world, in or to the Images and any materials comprising all or part of the Images.
10. I understand that some of the information provided by me, including, but not limited to, my
name, address, and date of birth (the “Information”) will be collected and used by the Released Party,
and I consent to the transmission of the Information to the Released Party, its agents and/or service
providers and authorize the Released Party, its agents and/or service providers to record, process and
store such Information as necessary for purposes of providing and administering the Activity. If any
provision of this agreement shall be unlawful, void or for any reason unenforceable, then that
provision shall be deemed severable from this agreement and shall not affect the validity and
enforceability of any remaining provisions.
11. I have fully read and understand this agreement. I am aware that by signing this agreement,
I am waiving certain legal rights I or my heirs, next of kin, executors, administrators and assigns
may have against the Released Party.
12. This Event Release and waiver will be construed in accordance with the laws of the State
of Florida. Each party irrevocably submits to the exclusive jurisdiction of the state and federal
courts located in Florida with respect to resolution of disputes arising under this Agreement.
Signature:
Printed Name:
Dated: / /