PATH Consent and Waiver Agreement

I have agreed to voluntarily participate in a wellness program presented by VEHI Planned Action Toward Health (“PATH”), through my employer, health plan, or association. As consideration for my participation in this PATH program, I hereby agree to the PATH Terms of Use, and provide the following consent and waiver to PATH.

I hereby acknowledge that I have read any introductory material provided by PATH, relating to the wellness program that I have chosen to undertake. I have been provided with an opportunity to ask PATH any questions I may have about the program, its demands on me, and any dangers that may be associated with engaging in any form of physical activity.

I hereby acknowledge and agree that I have provided truthful information to PATH regarding my general health, treatment, care, medical history, and fitness, and have provided PATH with all information they have requested of me in connection with the program. I understand that the information I have provided to PATH about my health, treatment, care, medical history and/or fitness shall be treated as strictly confidential and will only be disclosed for limited purposes, such as the design or implementation of my wellness program and responding to any health or safety issues that may arise during the course of my participation in the program.

I agree to follow the instructions of PATH during the course of the wellness program, and to abide by PATH security, safety and website usage policies and procedures at all times during my participation in the wellness program. I agree to report immediately to PATH any and all health issues, concerns or injuries that I may have during the course of my participation in the wellness program (no matter how slight), and to discuss my participation in PATH and my health status with my primary medical provider.

I know the risk and danger to myself or my property which might arise from any type of strenuous physical activity I may choose to engage in during the wellness program. I understand and hereby assume the health and safety risks that are inherent in this type of physical activity, which include but are not limited to: physical injuries, illnesses, or death resulting from physical exertion and exercise. I also understand and assume the risks of loss or damage to any personal equipment I may use during the course of the wellness program and my personal property.

I understand and agree that my failure to abide by the rules and directives of the wellness program or PATH while I am participating in this wellness program may result in the termination of my participation.

I voluntarily, and in reliance upon my own judgment and ability, hereby expressly release and hold harmless PATH, its directors, officers, employees and agents, from any and all claims, losses, damage or liabilities, including but not limited to personal injuries, death or property damage resulting from my participation in the above-described wellness program.

BY CLICKING ON THE TERMS BOX IN THE “MY PROFILE” SECTION OF MY PATH ACCOUNT, I REPRESENT AND ACKNOWLEDGE THAT I HAVE READ THE TERMS OF USE, AND RELEASE OF LIABILITY SET FORTH ABOVE, AND I AGREE TO BE BOUND THEREBY.