Waiver

Notice: This form contains a release and waiver of liability and when signed is a contract between the
undersigned participant and Ryse Recovery LLC with legal consequences. Please read this Agreement,
consisting of one (1) page in its entirety, carefully before signing your name at the bottom of the
page. This form must be signed in the presence of one (1) witness who should sign as witness.
Date of Execution of Release and Waiver of Liability: The undersigned agrees that this “Activities
Release and Waiver of Liability” form agreement is valid from the date of execution through the date
of discharge.
Acknowledgments and Representations by Client:The undersigned is currently a client
of Ryse Recovery LLC. The undersigned has voluntarily consented to participate in normal daily
activities such as walking down stairs, taking a shower, voluntary sports activities or voluntary
physical activities such as volleyball, aerobics, and other such types of voluntary sports or physical
activities, which may not be specifically identified herein, while being a client at such facility. The
undersigned acknowledges and represents that his participation in such sports activities and physical
activities is not a mandatory requirement of Ryse Recovery LLC, and that any participation by the
undersigned in any and all sports related activities and physical activities, is purely voluntary and of
the undersigned’s own free will. The undersigned acknowledges and represents that there has been
no coercion or force on the part of Ryse Recovery LLC for the undersigned to execute this release and
waiver of liability agreement. The undersigned has knowingly, freely and voluntarily consented to
execute this release and waiver of liability agreement. The undersigned acknowledges and
understands that it is the undersigned’s sole decision to participate in such voluntary activities. The
undersigned acknowledges and represents that he/she has been informed that he/she has an
absolute right to refuse to participate in any and all sports related activities or physical activities.
To Ryse Recovery LLC: In consideration of the opportunity afforded to me, by Ryse Recovery, to
participate in voluntary sports activities or voluntary physical activities such as volleyball, aerobics,
and any other similar types of voluntary sports or physical activities which may not be specifically
identified herein, the undersigned client freely agrees to make the following contractual
representations and agreements with Ryse Recovery LLC.
The undersigned client, does hereby knowingly, freely, and voluntarily assume all liability for any
damage or injury that may occur as a result of my (or my dependent/ward) participation in the
activities described herein and agree to release, waive, discharge, and covenant not to
sue Ryse Recovery LLC, its officers, agents, employees, and volunteers from any and all liability or
claims that may be sustained by me or a third party directly or indirectly in connection with, or
arising out of participation in the activities described herein, whether caused in whole or in part by
the negligence of Ryse Recovery LLC, or otherwise.
The undersigned client, has read this form, fully understand its terms, and understand that, I have
given up substantial rights by signing it and have signed it freely and without any inducement or
assurance of any nature and intend it to be a complete and unconditional release of any and all
liability to the greatest extent allowed by law, and I agree that if any portion of this contract is held
to be invalid the balance notwithstanding, shall continue in full legal force and effect.
I also agree that the rules provided to me by Ryse Recovery LLC, will be followed during the course of
my voluntary participation in the activities and or normal daily activities described herein. Otherwise,
my privilege of participating in such activities will be revoked immediately. Each client must sign a
release and waiver of liability form in order to participate in the voluntary activities or reside
at Ryse Recovery LLC described herein. I acknowledge that due to the nature of the activities
described herein, Ryse Recovery LLC staff will not be able to prevent injuries from occurring during
the course of such activities; therefore, I am choosing to participate in such activities at my own risk
and agree to assume all risks associated therewith.
Indemnification of Ryse Recovery LLC:The undersigned client shall at all times hereafter indemnify,
hold harmless and, at Ryse Recovery LLC Attorney’s option, defend or pay for an attorney selected
by Ryse Recovery LLC to defend Ryse Recovery LLC, its officers, agents, servants, and employees
against any and all claims, losses, liabilities, and expenditures of any kind, including attorney fees,
court costs, and expenses, caused by negligent act or omission of the client, other
clients, Ryse Recovery LLC, its employees, agents, servants, or officers, or accruing, resulting from, or
related to the undersigned client engaging in any voluntary sports activities or voluntary physical
activities such as volleyball, aerobics, and any other similar types of voluntary sports or physical
activities which may not be specifically identified herein, including, without limitation, any and all
claims, demands, or causes of action of any nature whatsoever resulting from injuries or damages
sustained by any person or property. The provisions of this section shall survive the expiration or
earlier termination of this Agreement or the discharge of the client from the residential/outpatient
facility operated by Ryse Recovery LLC

Signature:
Signature

Date:
Date