GYM LIABILITY WAIVER FORM

INSTRUCTIONS: PLEASE READ CAREFULLY BEFORE SIGNING!

I, INSERT NAME (“Participant”), acknowledge and understand that engaging in physical exercise, fitness, strength and conditioning activities may involve strenuous physical activity and may be hazardous to my health and well-being. Before beginning such activities, I understand that I should seek qualified medical advice concerning the risk and benefits of such activities.

In full consideration of being allowed to participate in physical activity, strength and conditioning programs and related activities, I hereby RELEASE, WAIVE, DISCHARGE AND AGREE TO INDEMNIFY and hold harmless INSERT NAME OF YOUR GYM/TRAINING FACILITY and its owners, operators, staff, faculty, instructors, trainers and associated subsidiaries from any loss, liability, damages and/or costs (including court costs and attorney’s fees) caused by or arising out of physical exercise, fitness, strength and conditioning activities, programs and opportunities offered by such entity. I understand and agree that any such activity involves the potential for death, serious injury, and disability and that I am solely responsible for my own health and welfare.

I hereby voluntarily participate in physical exercise, fitness, strength and conditioning activities and programs voluntarily and I assume all risks of injury (including death) and property damage connected therewith.

Furthermore, I should be aware of my own capabilities and limitations. I will not to participate in activities or use equipment that is beyond my capability. I hereby acknowledge and represent that I am physically sound and suffering from no medical, mental or physical condition that would prevent my participation in physical exercise, fitness, strength and conditioning activities or use of equipment other than those specifically highlighted. Should I have any medical or physical condition that could adversely affect my activities, it is my responsibility to make it known, and to obtain professional medical advice prior to commencement.

I agree to adhere to theIES' rules and regulations and agree to comply with the instructions of its staff and faculty members.

EMERGENCY CONTACT INFORMATION:
Name:________________________ Phone: _______________________

PARENT/GUARDIAN SIGNATURE (IF UNDER 18):
I am the parent or guardian of the individual whose name appears above, and I, for myself and/or my child/ward, consent and agree to my/their release and waiver of liability as set forth above.

SIGNATURE:
Signature of Participant: ___________________________

SIGNATURE OF PARENT OR GUARDIAN
(if Participant is under 18 years old)

Signature of Parent/Guardian: ___________________________

ADDITIONAL INFORMATION:
Name: ___________________________
Phone: __________________________
Email: __________________________

 

Participant is Age 18.

Name: Mobile Phone: Email:

*

 

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E-Sign Act Disclosure and Agreement

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Hardware & Software Requirements

Use of this Service Requirements

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  3. a PDF reader or browser capable of displaying Adobe PDF documents
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Electronic Signature         Disclosure & Consent