Loading...

 

F45 Health & Fitness Liability Waiver / Informed Consent Form


F45 Health & Fitness Liability Waiver / Informed Consent Form

This F45 Health & Fitness Liability Waiver/Informed Consent Form (“Release and Waiver”) is by and between KB Health & Fitness, LLC doing business as “F45 Training Manayunk” (“F45 Training Manayunk”) and the undersigned individual. I, the participant named below, in exchange for being allowed to use the F45 Training Manayunk facility (the “Facility”) and/or participate in the F45 workouts, exercise and training programs (collectively, the “Workouts”) hereby acknowledge and agree and represent as follows: The Workouts: • are a recreational sport activity that; • may involve strenuous physical activity including, but not limited to, muscle strength and endurance training, cardiovascular conditioning and training, and other various fitness activities. I understand that my participation in the workouts is inherently dangerous, and may involve substantial risk of injury, property damage and/or death. This risk of injury includes, but is not limited to, bruises, cuts, scrapes, broken bones, muscle pain, heart attack, stroke, and other serious physical injuries. • I KNOWINGLY AND FREELY ASSUME ALL RISK OF INJURY AND/OR PROPERTY DAMAGE ARISING FROM MY USE OF THE F45 TRAINING MANAYUNK FACILITY AND/OR PARTICIPATION IN THE WORKOUTS, BOTH KNOWN AND UNKNOWN, EVEN IF ARISING FROM THE NEGLIGENCE OF THE COMPANIES OR OTHERS, AND ASSUME FULL RESPONSIBILITY FOR MY USE OF THE FACILITY AND/OR PARTICIPATION IN THE ACTIVITIES. I hereby affirm, and I affirm each time I participate in a Workout, that: • I am in good physical condition and do not suffer from any known disability or condition which would prevent or limit my participation in this exercise program, and that; • I am participating in the Workouts voluntarily and at my own risk. I understand that an examination by a physician should be obtained prior to my participation in the Workouts. If I have chosen not to obtain a physicians consent prior to participating in the Workouts, I acknowledge that I am doing so at my own risk. If I have any questions or concerns about whether my usage of the Facility and or participation in the Workouts are appropriate considering my current health status, I understand that it is my responsibility to ask my doctor before I participate. I HEREBY RELASE F45 TRAINING PTY LTD, F45 TRAINING MANAYUNK, AND THEIR RESPECTIVE OWNERS, OFFICERS, AGENTS, AND EMPLOYEES (THE “RELEASED PARTIES”) FROM ANY CLAIMS, DEMANDS, AND CAUSES OF ACTION WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, LOSS OR DAMAGE TO PERSON OR PROPERTY ARISING DUE TO MY USE OF F45 Training Waiver Informed Consent.Docx 2 THE FACILITY AND/OR MY VOLUNTARY PARTICIPATION IN THE WORKOUTS (WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASED PARTIES OR OTHERWISE), TO THE EXTENT PERMITTED BY LAW. I fully understand that I may injure myself as a result of my participation in the workouts and I hereby release the Released Parties from any liability now or in the future for conditions that I may obtain directly or indirectly from participating in the Workouts, to the fullest extent permitted by law. These conditions may include, but are not limited to, heart attacks, muscle strains muscle pulls, muscle tears, broken bones, skin splints, heat prostration, injuries to knees, injuries to back, injuries to foot, or any other illness or soreness that I may incur, including death. I HAVE NEITHER REQUESTED NOR RECEIVED ANY EXPRESS REPRESENTATIONS OR WARRANTIES AS TO THE CONDITION OF THE FACILITY OR MY PARTICIPATION IN THE ACTIVITIES, AND F45 TRAINING MANAYAUNK HAS NOT MADE AND DOES NOT MAKE ANY ACTUAL OR IMPLIED REPRESENTATIONS OR WARRANTIES REGARDING SUCH MATTERS. I agree to defend, indemnify and hold harmless the Released Parties against any and all losses, damages, liabilities, deficiencies, claims, actions, judgements, settlements, interest, awards, penalties, fines, costs, or expenses of whatever kind, including attorneys’ fees, arising out of or in any way resulting from (directly or indirectly) my use of the Facility and/or my participation in the Workouts. This Release and Waiver shall also bind my heirs, executors, administrators, distributes, guardians, and next of kin. This Release and Waiver shall be governed by the laws of the Commonwealth of Pennsylvania, without giving effect to conflict of law principles. If any term or provision of this Release and Waiver is held to be illegal, invalid, or unenforceable, or the application thereof to any person or circumstances shall to any extent be illegal, invalid or unenforceable under present or future law, then it is the express intention of the parties that the remainder of this release and waiver, or the application of such terms, clauses or provision other than to those as to which if is held illegal, invalid or unenforceable, shall not be affected thereby, and each term, clause, or provision of this release and waiver, and the application thereof, shall be legal, valid, and enforceable to the fullest extent permitted by law. This Release and Waiver together with the F45 Training Manayunk Membership agreement, constitutes the entire agreement of the parties with respect to the subject matter of this release and waiver and supersedes all prior agreements, understandings, negotiations, statements, promises and discussions, oral and written, between the parties hereto with respect to the subject matter of this release and waiver. I understand and acknowledge that my execution of this release and waiver is a material inducement to F45 Training Manayunk allowing me to use the Facility and participate in the Workouts. The provisions of this Release and Waiver will continue in full force and effect even after the termination of my right to use the Facility or participate in the Workouts. I HEREBY AFFIRM THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE STATEMENTS.

Cold Plunge

Getting into a cold plunge is not an activity to be taken lightly, and if you do decide to do it, you should be in relatively good shape first. The risks of this activity include:

 

1. The cold water will generate an enormous shock to your system. An initial “cold shock” may leave you gasping for air and unable to hold your breath. Blood vessels along your outer body will constrict, attempting to shift blood to your inner organs. Your muscles will get very cold and may become temporarily paralyzed or weak.

 

2. A cold plunge may increase your risk of heart attack. For those at risk of stroke, aneurysm, blood pressure problems, or heart disease, the constricting of blood vessels and extra stress on your body can be especially dangerous. Even among healthy people, the adrenaline release that occurs during a cold plunge can lead to irregular heart rhythms.

 

3. A cold plunge may increase your risk of stroke. When temperatures decline, your blood pressure tends to go up, particularly in older persons. On average, systolic blood pressure may be up to five points higher in winter than in summer. When you are cold, your arteries may constrict, which means your blood must be pumped with greater pressure in order to reach all areas of your body. The higher blood pressure is one of the largest risk factors for stroke. In other words, exposure to cold temperatures may lead to a rise in your blood pressure that in turn, raises your stroke risk. If you know you have high blood pressure, are at an increased risk of stroke, or are elderly, cold plunges may pose too much of a risk for you. Even if you are healthy, you should prepare yourself for the polar plunge by immersing yourself on a regular basis, or “prime” your body for the plunge by taking gradually colder showers for a few days. This may help you develop a tolerance of sorts to the cold water. It is also important to immerse yourself in the water gradually, by walking in as opposed to jumping in which leads to such a sudden change in your body temperature that may cause a heart attack.

 

I agree to take full responsibility for myself as I use the cold plunge at F45 Training Manayunk facility. I accept that I am participating in hydrotherapy in using the cold plunge and I assume all risk unto myself. I declare myself physically and mentally capable to participate in cold therapy. I will not misrepresent myself to any agents/staff of F45 Training Manayunk about my ability to operate all equipment while at F45 Training Manayunk.

 

 

 

 

I understand that this written waiver is to serve as the primary source of information and education of the use of the cold plunge room, and the facility.

 

 

 

 

 

 




First Client's Name

First Name*

Middle Name

Last Name*

Phone*
First Client's Date of Birth*
First Client's Signature*
Second Client's Name

First Name*

Middle Name

Last Name*
Second Client's Date of Birth*
Third Client's Name

First Name*

Middle Name

Last Name*
Third Client's Date of Birth*
Fourth Client's Name

First Name*

Middle Name

Last Name*
Fourth Client's Date of Birth*
Fifth Client's Name

First Name*

Middle Name

Last Name*
Fifth Client's Date of Birth*
Sixth Client's Name

First Name*

Middle Name

Last Name*
Sixth Client's Date of Birth*
Seventh Client's Name

First Name*

Middle Name

Last Name*
Seventh Client's Date of Birth*
Eighth Client's Name

First Name*

Middle Name

Last Name*
Eighth Client's Date of Birth*
Ninth Client's Name

First Name*

Middle Name

Last Name*
Ninth Client's Date of Birth*
Tenth Client's Name

First Name*

Middle Name

Last Name*
Tenth Client's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!