Loading...

Max Fitness Crossfit 2639 Mission St, San Francisco CA 94110

Max Fitness CrossFit

Waiver, Release, and Assumption of Risk Form

 

 

I, , have been informed of, understand and am aware that any exercise program, whether or not requiring the use of exercise equipment, is a potentially hazardous activity. I also have been informed of, understand and am aware that any exercise and/or fitness activities involve a risk of injury, as well as abnormal changes occurring during or following exercise which may include abnormalities of blood pressure or heart rate, chest, arm or leg discomfort; transient light headedness or fainting, and a remote risk of heart attack, stroke, other serious disability or death. I have been informed of, understand and am aware that the programs and classes offered by Max Fitness CrossFit are of a nature and kind that are extremely strenuous and can/may push me to the limits of my physical abilities, and that I am voluntarily participating in these activities and using equipment and machinery with full knowledge, understanding and appreciation of the dangers involved. I hereby agree to expressly assume and accept any and all risks of injury, regardless of severity, or death.

 

 

I have been advised that an examination by a physician should be obtained by anyone prior to commencing a fitness and/or exercise program, or initiating a substantial change in the amount of regular physical activity performed. If I have chosen not to obtain a physicians consent prior to participating in the Max Fitness CrossFit, I hereby agree that I am doing so solely at my own risk. In any event, I acknowledge and agree that I assume the risks associated with any and all fitness related activities and/or exercises in which I participate.

 

I acknowledge that I have voluntarily chosen to participate in the CrossFit, which may include, but may not be limited to, resistance training and aerobic or cardiovascular exercise. I, my heirs, executors, partners, family members, attorneys, insurers, agents, representatives, executors, administrators, successors, assigns, and all those who claim through them or could claim through them, do here now and forever release and discharge and hereby hold harmless Max Fitness CrossFit, Olivio, LLC, and each of their present, former and future parents, predecessors, successors, assigns, assignees, affiliates, subsidiaries, divisions, owners, partners, principals, trustees, creditors, shareholders, joint ventures, officers, directors (whether acting such capacity or individually), attorneys, vendors, accountants, nominees, agents, (alleged, apparent or actual), representatives, employees, managers, administrators, contractors, volunteers, and/or each person or entity acting or purporting to act for them or on their behalf (collectively referred to as Releasees) from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting there from.

 

Photo/Video Release: I hereby grant Max Fitness CrossFit permission to use my photograph/video image in any and all publication for CrossFit or Max Fitness CrossFit, including website entries, without payment or any other consideration in perpetuity. I hereby authorize Max Fitness CrossFit to edit, alter, copy, exhibit, publish or distribute all photos or images. I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my photos appear. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph or video images. I hereby hold harmless and release and forever discharge Max Fitness CrossFit from all claims, demands and causes of actions which I, my heirs, executors, partners, family members, attorneys, insurers, agents, representatives, executors, administrators, successors, assigns, and all those who claim through them or could claim through them.

 

Indemnification: I recognize that there is risk involved in the types of activities offered by Max Fitness CrossFit. Therefore, I accept financial responsibility for any injury that I may cause either to myself or to any other participant due to his/her negligence. Should the above-mentioned parties, or anyone acting on their behalf, be required to incur attorneys fees and costs to enforce this agreement. I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless the Releasees from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in activities offered by Max Fitness CrossFit.

 

THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES WHICH MAY OCCUR AS A RESULT OF (1) EQUIPMENT BELONGING TO RELEASEES OR TO MYSELF THAT MAY MALFUNCTION OR BREAK; (2) ANY SLIP, FALL, DROPPING OF EQUIPMENT; AND/OR (3) NEGLIGENT INSTRUCTION OR SUPERVISION.

 

I ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS FORM IN ITS ENTIRETY AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I AM ALSO AGREEING TO CONSENT OF ALL PHOTOS THAT WILL BE TAKEN DURING CROSSFIT MAY BE SHARED AND USED BY MAX FITNESS CROSSFIT. BY SIGNING THIS DOCUMENT, I AM WAIVING ANY RIGHT I OR MY SUCCESSORS MIGHT HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST THE RELEASEES FOR NEGLIGENCE ON THE PART OF MYSELF, MY TRAINING PARTNER, OTHER PEOPLE AROUND ME, OR THE RELEASEES.

 

This form is an important legal document that explains the risks you are assuming by beginning an exercise program. It is critical that you have read and understand this document completely. If you do not understand any part of this

document, it is your ultimate responsibility to ask for clarification prior to signing it.

 

 

 

Participants signature Date

 

 

Please print name

 

 

Parent or legal guardian (if participant is under age eighteen) Date

First Athlete Name

First Name*

Middle Name

Last Name*

Phone*
First Athlete Date of Birth*
First Athlete Signature*
Second Athlete Name

First Name*

Middle Name

Last Name*
Second Athlete Date of Birth*
Third Athlete Name

First Name*

Middle Name

Last Name*
Third Athlete Date of Birth*
Fourth Athlete Name

First Name*

Middle Name

Last Name*
Fourth Athlete Date of Birth*
Fifth Athlete Name

First Name*

Middle Name

Last Name*
Fifth Athlete Date of Birth*
Sixth Athlete Name

First Name*

Middle Name

Last Name*
Sixth Athlete Date of Birth*
Seventh Athlete Name

First Name*

Middle Name

Last Name*
Seventh Athlete Date of Birth*
Eighth Athlete Name

First Name*

Middle Name

Last Name*
Eighth Athlete Date of Birth*
Ninth Athlete Name

First Name*

Middle Name

Last Name*
Ninth Athlete Date of Birth*
Tenth Athlete Name

First Name*

Middle Name

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

Email*

Confirm Email*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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.
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!