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WELCOME TO  GYM NYC East 3rd

I agree to be solely responsible for the safety and well being of my guest and myself. I understand that the company does not provide supervision, instruction, or assistance for the use of the facilities and equipment.

I agree to comply with all rules imposed by the company regarding the use of the facilities and equipment. I agree to conduct myself in a controlled and reasonable manner at all times, and to refrain from using any equipment in a manner inconsistent with its intended design and purpose.

I understand and agree that the company is not responsible for property that is lost, stolen, or damaged while in, on, or about the premises.

This waiver includes, but is not limited to, any loss, damage or destruction of the personal property of the MEMBER and is intended to be a complete release of any responsibility for personal injuries and/or property loss/damage sustained by any MEMBER while on the GYM NYC East 3rd premises, whether using exercise equipment or not.

IMPORTANT: RELEASE AND WAIVER OF LIABILITY AND INDEMNITY

I understand that strength, flexibility and aerobic activity, including the use of equipment, is a potentially hazardous activity involving: risk of injury, changes in blood pressure, fainting, and a remote risk of heart attack, stroke, other serious disability or death. I am voluntarily participating in these activities and using equipment and machinery with full knowledge, understanding and appreciation of the dangers involved. I understand that GYM NYC East 3rd will not provide supervision of my activities, unless personal training services are contracted. I hereby agree to expressly assume and accept any and all risks of injury, regardless of severity, or death. I also state that to the best of my knowledge, I have no current medical condition that would prohibit me from participating in these aforementioned activities.  

Further, I hold GYM NYC East 3rd and its agents and employees harmless for any injury, damage or loss to my person and/or property sustained while in the club except those due to gross negligence. 

I HAVE READ THE FOREGOING WAIVER AND RELEASE OF LIABILITY AND VOLUNTARILY EXECUTED THIS DOCUMENT WITH FULL KNOWLEDGE OF ITS CONTENT.

Fill out the waiver by scanning Your Driver's License

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First Participant's Name

First Name*

Last Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

Email*
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
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Please Upload Photo *
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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*

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.


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