JoyWell Core Membership Please enable JavaScript in your browser to complete this form.Member Name *Address *Home/Cell Phone *Email Address *Date of Birth *Emergency Contact(s) *Emergency Contact(s) Phone *Additional Family MembersFamily Home/Cell PhoneFamily Email AddressFamily Date of BirthPrimary Care Physician *Terms of Service *I agree to the Terms of Service listed belowORTHOWELL HEALTH AND WELLNESS MEMBERSHIP AGREEMENT This Health and Wellness Membership Agreement (this “Agreement”) is made and entered into on the date noted on the signature page of this Agreement (the “Effective Date”) by and between JOYWELL HEALTH & WELLNESS, LLC, a Florida limited liability company, d/b/a (“ORTHOWELL”) and the individual listed as the member on the signature page of this Agreement (the “MEMBER”). I. TERM OF AGREEMENT. Unless terminated sooner as otherwise set forth herein, the term of this Agreement shall commence on the Effective Date and shall continue throughout the membership enrollment period as provided in Section B above. II. SERVICES PROVIDED. The services of ORTHOWELL consist of the following: A. Nutritional Services. An ORTHOWELL membership will include functional nutrition counseling sessions offered by our nutrition experts. The functional perspective of nutrition offered by ORTHOWELL will focus on how growth, metabolism, and repair have different physiological requirements dependent on the individual and that a personalized approach to diet and lifestyle modification will be the key for success. Personalized nutritional protocols will be offered to help educate members around optimizing weight loss and weight management, digestion, blood sugar management, detoxification, immunity, inflammation and healing, environmental inputs, oxidative stress and energy production, and balancing of hormones and neurotransmitters. B. Performance Coaching. ORTHOWELL’S experts will inspire and support members in achieving their goals, realizing their potential, and upgrading their mind, body and energy through member-centered health and wellness coaching sessions. Strategies surrounding these sessions will include, but are not limited to, building better habits, sleep optimization, mindfulness, stress reduction and resilience, and improving energy and cognitive performance. C. Personal Training. An ORTHOWELL membership will include access to a network of vetted strength training professionals giving members the ability to enhance their fitness levels. D. Recovery, Physician Access & Referrals. Members will have access to our volunteer medical director, Patrick W. Joyner, M.D. (“DR. JOYNER”), for evaluations as well as access to associates of Dr. Joyner who specializes in orthopedics and physical therapy. In addition, an ORTHOWELL membership will provide access to our extensive network of health and wellness professional who offer a variety of musculoskeletal rest and recovery services including, but not limited to, massage therapy, acupuncture, cryotherapy, and chiropractic care. E. OrthoWell Plus Services. In addition to the above services provided, the OrthoWell Pro Memberships further include four custom meal plans and four custom fitness programs, powered by TriCore Wellness. III. CANCELLATION POLICY. MEMBER may cancel this Agreement at any time by providing written notice of termination to ORTHOWELL. All monies paid pursuant to this Agreement shall be refunded to MEMBER within ten (10) days of the receipt of the notice of cancellation, except for payment that applies to any health and wellness services received prior to such notice of cancellation. IV. NO GUARANTY OF RESULTS. MEMBER acknowledges and agrees that no warranties or guarantees have been made by ORTHOWELL regarding the results MEMBER will achieve from ORTHOWELL’S health and wellness services. MEMBER understands results vary from individual to individual. VI. ACKNOWLEDGEMENT OF HEALTH. MEMBER hereby declares himself/herself physically and mentally sound and suffering from no condition, impairment, disease, infirmity, or other illness that would prevent his/her participation in any ORTHOWELL’S health and wellness program. MEMBER acknowledges that he/she has either had a physical examination and been given his/her physician’s permission to participate in a health and wellness program offered by ORTHOWELL, or if MEMBER has chosen not to obtain a physician’s permission prior to beginning a health and wellness program with ORTHOWELL, MEMBER hereby acknowledges that he/she is doing so at his/her own risk. VIII. ASSUMPTION OF RISK. MEMBER understands and is aware that physical activities, including the use of fitness equipment, are potentially hazardous activities. MEMBER acknowledges the possibility that injuries and physical and mental changes arising during and/or resulting from engaging in such activities does exist. Injuries and changes include, but are not limited to, abnormal blood pressure, fainting, disorders in heartbeat, heart attack, and, in some instances, disability or death. MEMBER acknowledges that he/she is voluntarily participating in health and wellness coaching/training sessions and using exercise equipment with knowledge of the dangers involved. MEMBER understands and takes sole responsibility for any and all injuries and changes that may occur related to any and all activities associated with ORTHOWELL’S instruction, even if not specifically set forth in this Agreement, whether or not they fall within the scope of reasonably foreseeable injuries related to such activities, and whether or not undertaken in an associate of ORTHOWELL’S presence. Although ORTHOWELL will take precautions to ensure MEMBER’S safety, MEMBER expressly assumes and accepts sole responsibility for his/her safety and for any and all injuries and physical or mental changes that may occur. IX. WAIVER AND RELEASE OF LIABILITY. In consideration of ORTHOWELL’s agreement to provide MEMBER with instruction, assistance, consultation, health and wellness advice and/or training, Member hereby agrees to hold harmless ORTHOWELL, its respective representatives, executors, agents, and assigns from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected to MEMBER’S participation in any and all health and wellness activities, use of equipment, or any and all acts or omissions, including negligence by an associate or representative of ORTHOWELL. This waiver and release of liability includes, but is not limited to, (a) injuries and mental or physical changes to MEMBER that may occur as a result of (i) a health and wellness program or routine provided to MEMBER by ORTHOWELL; (ii) consultations, coaching or health and wellness advice offered by ORTHOWELL or third party referral; (iii) any facility equipment that may malfunction or break; (iv) any and all defects, latent or apparent, in the design or condition of equipment; (v) any and all slips, falls at an ORTHOWELL training facility; (vi) any and all improper maintenance of equipment or training facilities; (viii) any hazardous condition that may exist at an ORTHOWELL training facility, including, but not limited to, the specific workout area; and (ix) negligent instruction or supervision by and ORTHOWELL associate or representative; (b) damage to property, including but not limited to, equipment and the training facility. MEMBER acknowledges that he/she has thoroughly read this waiver and release and fully understands it is a waiver and release of liability. By signing this Agreement, MEMBER waives any right that MEMBER, or MEMBER’S heirs and/or assigns, may have to bring any and all legal actions or assert any and all claims against ORTHOWELL, its respective representatives, executors, and/or assigns. X. INFORMATION, NOTICES & DISCLAIMERs CONCERNING ORTHOWELL’S VOLUNTEER MEDICAL DIRECTOR. DR. JOYNER is ORTHOWELL’S volunteer Medical Director. As a member of ORTHOWELL, you will be provided access to DR. JOYNER for purposes of evaluations, consultations and/or referral. Any and all medical care provided by DR. JOYNER will be through OrthoCollier, a Division of Neuroscience and Spine Associates, P.L., located at 1250 Pine Ridge Rd., Suite 202, Naples, FL 34108 (“ORTHOCOLLIER”). For purposes of clarity, DR. JOYNER will not be providing MEMBERS with medical care through ORTHOWELL or any of its subsidiaries. Formal medical care will only be provided on the premises of ORTHOCOLLIER. As a member of ORTHOWELL, your membership fees will allow for access to DR. JOYNER’S orthopedic practice and two referrals to consultants in the Southwest Florida area. Note that when being evaluated by DR. JOYNER at ORTHOCOLLIER, you will be required to pay the appropriate fees whether directly or through your insurance company (if such insurance is accepted by ORTHOCOLLIER.) Membership in ORTHOWELL is not a surrogate for medical services. As a member of ORTHOWELL you are provided consultation, references and/or referrals to musculoskeletal wellness providers in the area as well as preferred access to DR. JOYNER’S orthopedic practice. Additionally, you will be provided with wellness coaching if so desired. DR. JOYNER and ORTHOWELL are not responsible for care administered by referrals or consultations with third parties, including but not limited to: physicians, personal trainers, nutritionists, physical therapists, massage therapists or chiropractors. As a member of ORTHOWELL you are not obligated to consult with DR. JOYNER or obligated to see the referrals and/or consultants DR. JOYNER recommends. If you chose to see another orthopedic surgeon or consult with other health and wellness experts in Naples or elsewhere, DR. JOYNER will help facilitate that process. By signing this agreement, you hereby waive all HIPPA privacy obligations when correspondence is conducted via email, text, phone calls, and any other form of communication not conducted on the premises of ORTHOCOLLIER or other Neuroscience and Spine Associate office locations. This communication includes associates of ORTHOWELL, as well as with DR. JOYNER and his associates and staff. By waiving these privacy obligations, none of the aforementioned methods of communication will be considered formal medical care. XI. APPLICABLE LAW, VENUE, JURISDICTION & ATTORNEY FEES. This Agreement shall be construed and governed under and by the laws of the State of Florida, without giving effect to any choice or conflict of law provision or rule (whether of the State of Florida or of any other jurisdiction) that would cause the application of the laws of any jurisdiction other than the State of Florida. The parties agree that exclusive venue for any legal action authorized hereunder shall be Collier County, Florida, and that jurisdiction shall be vested in the state and federal courts therein and the appellate courts thereof, as the case may be. In the event either party is required to commence legal proceedings in order to enforce its rights or protect its interest hereunder, the prevailing party in such legal proceedings shall be paid its reasonable attorneys’ fees from the other party. XII. PARTIAL INVALIDITY. If any term or provisions of this Agreement, or the application thereof to any person or circumstance, shall be invalid or unenforceable, the remainder of this Agreement, or the application of such term or provision to persons or circumstances, other than those as to which it is held invalid, shall both be unaffected thereby and each term or provision of this Agreement shall be valid and be enforced to the fullest extent permitted by law. XIII. ENTIRE AGREEMENT. This Agreement sets forth the entire understanding of the parties concerning the subject matter hereof and incorporates all prior negotiations and understandings. There are no covenants, promises, agreements, conditions or understandings, either oral or written, between them relating to the subject matter of this Agreement other than those set forth herein. I HAVE READ THIS AGREEMENT, I HAVE TAKEN TIME TO CONSIDER ITS IMPLICATIONS, I FULLY UNDERSTAND ITS CONTENTS, I AGREE TO ITS TERMS, AND I VOLUNTARILY SUBMIT TO ITS EXECUTION. Member E-Signature *Effective Date *2nd Member E-Signature (if applicable)Effective DateSubmit