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Release/Assumption of Risk Agreement

In consideration of gaining access to participate in activities associated with CH FITNESS & PERFORMANCE (CHFP) at CROSSFIT SOUTH ARLINGTON (CFSA), I do hereby waive, release, and forever discharge CHFP and CFSA and its officers, agents, employees, representatives, executors, and all others from any and all responsibilities or liability for injuries or damages resulting from my participation in any activities.

I understand the policies and procedures set forth by CHFP and CFSA.I agree to abide by all rules, whether written or verbal, implied or expressed, as a condition of my participation and entry to the facilities.

I have the opportunity to discuss my specific needs in relation to participatory activity; and, as a result, I do voluntarily request the right to participate in this exercise and athletic program.

Also, in consideration of the above factors, I acknowledge the existence of risks in connection with these activities, assume such risks, and agree to accept the responsibilities for any injuries sustained by my participation in the course via the use of the facilities and/or its equipment. Most specifically, I acknowledge and accept responsibility for injuries arising out of those activities that involve risk in any of the following areas:

  • The use of facility equipment
  • The performance of fitness-related evaluations to assess functional capacity
  • The participation in group activities related to exercise and activity
  • The performance of Olympic-style weightlifting, strength training and all supportive exercises and training
  • Incidents that occur within the institution facility, locker rooms, dressing rooms, showers and other areas associated with CHFP and CFSA

In addition, it was seriously recommended that I consult with a physician before engaging in any activities associated with CHFP.

Having read the preceding, I acknowledge full understanding of those risks set forth herein and knowingly agree to accept full responsibility for my own exposures to such risks and to waive full responsibility and liability on behalf of CHFP and CFSA.

Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.

CHFP and CFSA have put in place preventative measures to reduce the spread of COVID-19; however, CHFP cannot guarantee that you will not become infected with COVID-19. Further, entering CHFP and CFSA premises could increase your risk of contracting COVID-19.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by entering CHFP and CFSA and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at CHFP and CFSA may result from the actions, omissions, or negligence of myself and others, including, but not limited to, CHFP and CFSA employees, volunteers, and program participants and their families.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at CHFP and CFSA or participation in CHFP programming (“Claims”). On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless CHFP, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of CHFP, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any CHFP program.

 

Photo, Video and Audio Consent and Release Form

From time to time photographs, videos, and/or audio clips may be taken of Cara Heads Slaughter training, coaching, teaching and instructing activities with and of those participating in her coaching, classes, clinics, and seminars. CH Fitness and Performance (CHFP), at this time, requests the right to use all photos, videos, and/or audio clips taken of instruction, testimonials, training, programs, and activities. These may be used for promotional brochures, promotions or showcase of programs on our web sites, social media accounts, showcase of activities, newspapers, magazine and products for non-profit and for profit.

By signing this form, I consent to allow CHFP use of photos, videos, and/or audio clips that they have of me participating in workouts or training with and under the auspices of Cara Heads Slaughter and/or CHFP.

By signing this form, I confirm that I understand and agree to the above request and conditions. I agree to give up my rights with regards to CHFP photos, videos, and/or audio clips of me. I sign this form freely and without inducement.

Date: August 8, 2020

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First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
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:*
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*

Last Name*

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