Fitness Release Form

FITNESS RELEASE AND WAIVER OF LIABILITY

Facility Name:

Participant Information

Date of Birth:    Phone:

Emergency & Medical Information

Emergency Contact Phone:    Primary Physician:

Assumption of Risk

I, the undersigned Participant, acknowledge that participation in fitness programs, classes, use of exercise equipment, personal training, and other physical activities offered by the Facility involves inherent risks including, but not limited to, strains, sprains, cardiac events, dislocations, fractures, paralysis, or death. I affirm that I knowingly and voluntarily assume all risks associated with participation and use of Facility premises and equipment, whether such risks are known or unknown, foreseeable or unforeseeable.

Release, Waiver, and Indemnification

In consideration of being permitted to participate in activities and use Facility services, I hereby release, waive, discharge, and covenant not to sue the Facility, its owners, officers, employees, instructors, agents and representatives (collectively, the Released Parties) from liability for any and all claims, demands, damages, losses, costs, or causes of action arising out of or relating to injury, illness, death or property damage resulting from my participation, whether caused by the negligence of the Released Parties or otherwise. I further agree to indemnify and hold harmless the Released Parties from any loss, liability, damage, or costs, including attorney's fees, incurred as a result of any claim brought by me or on my behalf.

Representation of Fitness

I represent and warrant that I am physically fit and sufficiently trained to safely participate in the activities I elect to undertake. I have disclosed above any medical conditions, physical limitations, or medications that could affect my safe participation. I understand it is my responsibility to consult with a physician before beginning any exercise program and to follow the instructions of Facility staff and instructors.

Emergency Medical Authorization

In the event of an emergency, I authorize Facility staff to obtain emergency medical treatment on my behalf and to disclose pertinent medical information to emergency responders or treating medical personnel. I understand that I am responsible for any costs associated with such treatment.

  I authorize emergency medical treatment as described above.

Policies, Media, and Confidentiality

I agree to comply with all Facility rules, policies, and instructions from staff. I grant the Facility the right to photograph or record me during activities and to use such images or recordings for promotional or instructional purposes, provided my name is not used without additional consent. Medical information provided herein will be kept confidential by the Facility except as required for emergency treatment or by law.

  I consent to the Facility's use of my likeness as described above.

Governing Law; Severability; Entire Agreement

This Release shall be governed by and construed in accordance with the laws of the state in which the Facility is located without regard to conflict of laws principles. If any provision of this Release is found to be invalid or unenforceable, the remaining provisions shall remain in full force and effect. This Release constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements and understandings, oral or written.

Acknowledgement

I certify that I have read and fully understand this Fitness Release and Waiver of Liability. I understand that by signing below I am giving up substantial legal rights, including the right to sue the Released Parties. I sign this Release freely and voluntarily.

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