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CONSENT WAIVER

RELEASE OF LIABILITY. READ CAREFULLY BEFORE SIGNING.

I hereby acknowledge that I freely and voluntarily wish to participate in the fitness, instruction, and exercise activities of CrossFit Stead Fast, LLC, and use its facilities, equipment, premises, and instructors/trainers. In consideration of that opportunity, participation, and use, in addition to any payments or charges, I hereby execute the Release of Liability with the intent to bind myself, my spouse, my children, my parents, my heirs, assigns, legal representatives, and any other person claiming under or through me.

I understand and agree that by participating in CrossFit SteadFast, LLC activities, I face risks of accidental and/or other physical or emotional injury. These risks may include, but are not limited to: (1) loss or damage to personal property; (2) injury or fatality; (3) physical exertion and heat exhaustion; (4) dehydration; (5) exposure to various on-and off- site premises and/or equipment and all the risk inherent therein, including slips, falls, collisions, and falling objects; (6) NEGLIGENT CO-PARTICIPANTS; and (7) strenuous and hazardous physical activities among others. Further, I agree that CrossFit SteadFast, LLC has no right of control or influence on the safety or security of the premises or its surroundings, including criminal activities on or near the CrossFit SteadFast, LLC premises. I understand and assume all risks EVEN IF RESULTING FROM NEGLIGENCE, AND EXPRESSLY AGREE TO WAIVE ALL CLAIMS FOR NEGLIGENCE.

I further represent that I have made CrossFit SteadFast, LLC aware of any and all current or past physical or mental disabilities, injuries, and/or problems which might limit my participation by listing them above and I will advise CrossFit SteadFast, LLC and its instructors/trainers at any point when I question my ability to participate in any activities.

I EXPRESSLY AGREE AND INTEND THAT MY PARTICPATION IN ALL CROSSFIT STEADFAST, LLC ACTIVITIES AND USE OF ALL EQUIPMENT OR FACILITIES SHALL BE UNDERTAKEN BY ME AT MY OWN RISK AND THAT NEITHER CROSSFIT STEADFAST, LLC, ITS EMPLOYEES, INSTRUCTORS, TRAINERS , MANAGERS, AGENTS NOR ASSIGNS SHALL BE LIABLE FOR ANY INJURIES, DAMAGES, CLAIMS, DEMANDS, ACTIONS, OR CAUSES OF ACTION WHATSOEVER WHICH MAY ARISE OUT OF OR IN CONNECTION WITH MY PARTICIPATION IN CROSSFIT STEADFAST, LLC ACTIVITIES WHETHER FROM ACTS OF OR ACTIVE PASSIVE NEGLIGENCE ON MY PART, OR THE PART OF ANYONE ELSE, AND I DO HEREBY AGREE TO FOREVER RELEASE, DISCHARGE, IDEMNIFY, HOLD HARMLESS AND DEFEND CROSSFIT STEADFAST, LLC, ITS EMPLOYEES , INSTUCTORS, TRAINERS, MANAGERS , AGENTS OR ASSIGNS FOR ANY SUCH INJURIES, DEATH, DAMAGES, CLAIMS, DEMANDS, ACTIONS, CAUSES OF ACTION, CLAIMS FOR NEGLIGENCE OR OTHER THEORIES OF LIABILITY AND/OR STRICT LIABILITY, COUNSEL TO BE CHOSEN BY CROSSFIT STEADFAST, LLC.

I authorize CrossFit SteadFast, LLC to take photographs and videotapes of me and to record my voice, conversation, grunts, groans, and other sounds during and in connection with CrossFit SteadFast, LLC activities. I acknowledge that CrossFit SteadFast, LLC shall own exclusively all copyright and other rights in and to such tapes, photography, and recordings and may use them forever and throughout the world in any manner without compensation to me. I authorize CrossFit SteadFast, LLC to use my name, voice, likeness, and biographical facts disclosed or provided to CrossFit SteadFast, LLC in advertising and promoting CrossFit Stead Fast, LLC specifically and/or CrossFit activities generally without further compensation.

The terms of this Release of Liability are to be governed by and construed under the laws of the State of Georgia. In the event any term or provision of the Release of Liability is found to be unenforceable or void, in whole or part, the term or provision concerned shall be construed as valid and enforceable to the maximum extent permitted by law, and the balance of the Release of Liability shall remain in fullforce and effect. I agree that exclusive venue for any dispute arising between CrossFit SteadFast, LLC and I involving the Release of Liability in any way shall be in Chatham County, Georgia.

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First Participant Name

First Name*

Last Name*

Phone*
First Participant Date of Birth*
I certify that I am 18 years of age or older
First Participant Signature*
Participant 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 Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Other Info

How many years in CrossFit? *

Name of Your Home Box *

Current or Past Injuries or Disabilities
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 Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian 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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