Loading...

Please sign this liability waiver.  Enjoy the facility responsibly.

WAIVER OF LIABILITY FOR GYM USE AND TRAINING

I hereby understand and acknowledge that the training, programs, and events held by Elevate Movement Collective, LLC may expose me to many inherent risks, including accidents, injury, illness, or even death. I assume all risk of injuries associated with participation, including, but not limited to, falls, physical stress and exertion, contact with other participants, contact with trainers, the effects of heat, the effects of the weather, including high heat and/or humidity and/or cold temperatures, and all other such risks involved with physical training being known and appreciated by me. I also understand that extensive physical contact with the trainer(s) and staff is a necessary and integral component of the requested training regimen with Elevate Movement Collective, LLC. I hereby acknowledge the professional necessity of the trainer’s/staff’s physical contact, I consent to such physical contact, and I agree to give notice to my trainer/staff and forego any instruction if, at any time, I am not comfortable with and do not voluntarily accept such physical contact.

I hereby acknowledge my responsibility in communicating any physical and psychological concerns that might conflict with participation in any activity. I acknowledge that I am physically fit and mentally capable of performing the physical activity I choose to participate in.

After having read this waiver and knowing these facts, in consideration of acceptance into the training program with Elevate Movement Collective, LLC, and in consideration of Elevate Movement Collective, LLC furnishing services to me, I agree, for myself and anyone entitled to act on my behalf (including but not limited to my heirs, executors, administrators, and/or attorneys), to RELEASE, HOLD HARMLESS, WAIVE AND FOREVER DISCHARGE Elevate Movement Collective, LLC its officers, agents, employees, organizers, representatives, and successors from any responsibility, liabilities, demands, or claims of any kind (including specifically, but not limited to, claims of negligence, and any intentional acts associated with physical participation with a trainer, against Elevate Movement Collective, LLC its officers, agents, employees, organizers, representatives, and successors) arising from or in any way connected with my participation in any activity with Elevate Movement Collective, LLC or entering or departing Elevate Movement Collective, LLC facilities. I voluntarily, in reliance upon my own judgment and ability, hereby assume all the risk of loss, damage, and injury of any kind regardless of severity.

By my signature I indicate that I have read and understand this Waiver of Liability. I am aware that this is a waiver and a release of liability and I voluntarily agree to its terms.

 

First Participant's Name

First Name*

Middle Name

Last Name*

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

Click to customize text box label
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Emergency Contact

Click to customize text box label
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Emergency Contact

Click to customize text box label
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Emergency Contact

Click to customize text box label
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Emergency Contact

Click to customize text box label
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Emergency Contact

Click to customize text box label
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Emergency Contact

Click to customize text box label
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Emergency Contact

Click to customize text box label
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Emergency Contact

Click to customize text box label
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Emergency Contact

Click to customize text box label
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
Check to receive information, news, and discounts by e-mail.
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*
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*
I certify that I am 18 years of age or older
Parent or Guardian's Emergency Contact

Click to customize text box label
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