Loading...

Upon signing this Agreement and forever thereafter, you (Buyer, each member and all guests) agree that if you engage in any physical exercise or activity, use any PDXstrength facility, or are present on the premises, you do so at your own risk and assume the risk of any and all injury and/or damage you might sustain, regardless of whether such injury or damage arises out of or during physical exercise. Your assumption of risk includes but is not limited to your use of any exercise equipment (mechanical or otherwise), the locker room, sidewalk, parking lot, stairs, pool, Cathedral park, whirlpool, sauna, steam room, racquet courts, lobby area, or any other part or item in or around the PDXstrength facility. You agree to assume the risk of your participation in any activity, class, program, instruction, or PDXstrength-sponsored event. You agree that you are voluntarily participating in the aforementioned activities and assume all risk, known and unknown, associated with using the PDXstrength facilities, equipment and premises including, without limitation, any loss or theft of any personal property. You agree on behalf of yourself (and your spouse, all your, children, personal representatives, heirs, executors, administrators, agents, and assigns) to forever release and discharge PDXstrength and our owners, employees, agents, representatives, volunteers, affiliates, successors, and assigns from any and all claims or causes of action (known or unknown) arising out of the negligence of PDXstrength, whether active or passive, or that of any of its affiliates, employees, agents, representatives, successors, and assigns. This waiver and release of liability includes, without limitation, injuries which may occur as a result of (a) your use of any exercise equipment or facilities which may malfunction or break, (b) PDXstrength’s improper maintenance of any exercise equipment or facilities, (c) PDXstrength's negligent instruction or supervision, including personal training, and (d) you slipping and falling while in the facility or any portion of the premises for any reason, including PDXstrength's negligent inspection or maintenance of its facility. By executing this Agreement, you hereby agree to indemnify and hold harmless PDXstrength from any loss, liability, damage, or cost PDXstrength may incur due to your presence at the PDXstrength facility. You further expressly agree that the foregoing release, waiver, and indemnity agreement is intended to be as broad and inclusive as permitted by the law of the state in which this agreement is entered into, and that if any portion of this agreement is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release is not intended as an attempted release of claims of gross negligence or intentional acts. You acknowledge that the PDXstrength is designed to and does offer a service to its members encompassing the entire fitness spectrum. The PDXstrength is not in the business of selling, leasing or otherwise placing into the stream of commerce weight lifting equipment, exercise equipment, or other such products, and the use of any such items is incidental to the service provided by PDXstrength. 

I have agreed to participate in PDXstrength.com Personal Training, Bootcamps, and/or indoor and outdoor fitness classes The activities of PDXstrength.com BootCamps, Classes and Personal Training, include strength training, running, agility drills, jumping, intense cardiovascular activities and flexibility training. Acknowledgment is hereby made that the activities of the camp, classes and training will require me to spend time outside in the heat, as well as inside. I further acknowledge that there are risks involved in participating in the boot camp. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, my physical condition, equipment, actions of other people including, but not limited to, participants, volunteers, and lack of hydration. In consideration of my being accepted into the program, I agree to release and discharge PDXstrength.com and any of its employees, volunteers and supervisors, PDXstrength.com Studio, Jocelyn Streng; owner of the studio, from any injuries sustained by me as a result of participation in this program. I agree to indemnify and hold harmless, PDXstrength.com, and any of its employees, volunteers and supervisors, facilities and owners of PDXstrength.com against any liability incurred as a result of such injury or loss. Fitness activities and programs require that I be in good health and have no condition that could endanger my well-being through participation. I will notify PDXstrength.com of any such defects in writing prior to enrolling in this program. The undersigned agrees to save and hold harmless and indemnify each and all of the parties referred to above from all liability, loss, cost, claim or damage whatsoever which may be imposed upon said parties because of any defect in or lack of such capacity to so act and release said parties on behalf of myself.

I grant to PDXstrength, its representatives and employees the right to take photographs of me and my property in connection with the above-identified subject. I authorize PDXstrength, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that PDXstrength may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

YOU ACKNOWLEDGE THAT YOU HAVE CAREFULLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY, AND EXPRESS ASSUMPTION OF RISK AND INDEMNITY AGREEMENT. YOU ARE AWARE AND AGREE THAT BY EXECUTING THIS WAIVER AND RELEASE, YOU ARE GIVING UP YOUR RIGHT TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST PDXstrength FOR ITS NEGLIGENCE, OR FOR ANY DEFECTIVE PRODUCT ON ITS PREMISES. YOU HAVE READ AND VOLUNTARILY SIGNED THE WAIVER AND RELEASE AND FURTHER AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS, OR INDUCEMENT APART FROM THE FOREGOING WRITTEN AGREEMENT HAS BEEN MADE. YOU AGREE, FOR YOURSELF AND YOUR SPOUSE, CHILDREN, SUCCESSORS, HEIRS AND ASSIGNS, THAT THE ABOVE REPRESENTATIONS ARE CONTRACTUALLY BINDING, AND ARE NOT MERE RECITALS, AND THAT SHOULD YOU OR YOUR SUCCESSORS ASSERT ANY CLAIM IN CONTRAVENTION OF THIS AGREEMENT, THE ASSERTING PARTY SHALL BE LIABLE FOR THE EXPENSES (INCLUDING REASONABLE ATTORNEYS FEES) INCURRED BY THE OTHER PARTY OR PARTIES IN DEFENDING AGAINST ANY SUCH ACTION. 

Today's date: May 5, 2024

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Do you: Smoke?*
No
Yes
Drink alcohol?*
No
Yes
Take prescription meds?*
No
Yes
Are you exercising now?*
No
Yes

How much per week?
Do you play sports? *
No
Yes
Do you have: Back pain, Knee pain or Shoulder pain?*
No
Yes
Previous Injuries or Surgeries?*
No
Yes
High blood pressure, Asthma, Diabetes, or a Heart condition?*
No
Yes
Any other health conditions not listed?*
No
Yes
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Do you: Smoke?*
No
Yes
Drink alcohol?*
No
Yes
Take prescription meds?*
No
Yes
Are you exercising now?*
No
Yes

How much per week?
Do you play sports? *
No
Yes
Do you have: Back pain, Knee pain or Shoulder pain?*
No
Yes
Previous Injuries or Surgeries?*
No
Yes
High blood pressure, Asthma, Diabetes, or a Heart condition?*
No
Yes
Any other health conditions not listed?*
No
Yes
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Do you: Smoke?*
No
Yes
Drink alcohol?*
No
Yes
Take prescription meds?*
No
Yes
Are you exercising now?*
No
Yes

How much per week?
Do you play sports? *
No
Yes
Do you have: Back pain, Knee pain or Shoulder pain?*
No
Yes
Previous Injuries or Surgeries?*
No
Yes
High blood pressure, Asthma, Diabetes, or a Heart condition?*
No
Yes
Any other health conditions not listed?*
No
Yes
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Do you: Smoke?*
No
Yes
Drink alcohol?*
No
Yes
Take prescription meds?*
No
Yes
Are you exercising now?*
No
Yes

How much per week?
Do you play sports? *
No
Yes
Do you have: Back pain, Knee pain or Shoulder pain?*
No
Yes
Previous Injuries or Surgeries?*
No
Yes
High blood pressure, Asthma, Diabetes, or a Heart condition?*
No
Yes
Any other health conditions not listed?*
No
Yes
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Do you: Smoke?*
No
Yes
Drink alcohol?*
No
Yes
Take prescription meds?*
No
Yes
Are you exercising now?*
No
Yes

How much per week?
Do you play sports? *
No
Yes
Do you have: Back pain, Knee pain or Shoulder pain?*
No
Yes
Previous Injuries or Surgeries?*
No
Yes
High blood pressure, Asthma, Diabetes, or a Heart condition?*
No
Yes
Any other health conditions not listed?*
No
Yes
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Do you: Smoke?*
No
Yes
Drink alcohol?*
No
Yes
Take prescription meds?*
No
Yes
Are you exercising now?*
No
Yes

How much per week?
Do you play sports? *
No
Yes
Do you have: Back pain, Knee pain or Shoulder pain?*
No
Yes
Previous Injuries or Surgeries?*
No
Yes
High blood pressure, Asthma, Diabetes, or a Heart condition?*
No
Yes
Any other health conditions not listed?*
No
Yes
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Do you: Smoke?*
No
Yes
Drink alcohol?*
No
Yes
Take prescription meds?*
No
Yes
Are you exercising now?*
No
Yes

How much per week?
Do you play sports? *
No
Yes
Do you have: Back pain, Knee pain or Shoulder pain?*
No
Yes
Previous Injuries or Surgeries?*
No
Yes
High blood pressure, Asthma, Diabetes, or a Heart condition?*
No
Yes
Any other health conditions not listed?*
No
Yes
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Do you: Smoke?*
No
Yes
Drink alcohol?*
No
Yes
Take prescription meds?*
No
Yes
Are you exercising now?*
No
Yes

How much per week?
Do you play sports? *
No
Yes
Do you have: Back pain, Knee pain or Shoulder pain?*
No
Yes
Previous Injuries or Surgeries?*
No
Yes
High blood pressure, Asthma, Diabetes, or a Heart condition?*
No
Yes
Any other health conditions not listed?*
No
Yes
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Do you: Smoke?*
No
Yes
Drink alcohol?*
No
Yes
Take prescription meds?*
No
Yes
Are you exercising now?*
No
Yes

How much per week?
Do you play sports? *
No
Yes
Do you have: Back pain, Knee pain or Shoulder pain?*
No
Yes
Previous Injuries or Surgeries?*
No
Yes
High blood pressure, Asthma, Diabetes, or a Heart condition?*
No
Yes
Any other health conditions not listed?*
No
Yes
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Do you: Smoke?*
No
Yes
Drink alcohol?*
No
Yes
Take prescription meds?*
No
Yes
Are you exercising now?*
No
Yes

How much per week?
Do you play sports? *
No
Yes
Do you have: Back pain, Knee pain or Shoulder pain?*
No
Yes
Previous Injuries or Surgeries?*
No
Yes
High blood pressure, Asthma, Diabetes, or a Heart condition?*
No
Yes
Any other health conditions not listed?*
No
Yes
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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:*
Emergency Contact

First Name*

Last 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.


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 Information
Do you: Smoke?*
No
Yes
Drink alcohol?*
No
Yes
Take prescription meds?*
No
Yes
Are you exercising now?*
No
Yes

How much per week?
Do you play sports? *
No
Yes
Do you have: Back pain, Knee pain or Shoulder pain?*
No
Yes
Previous Injuries or Surgeries?*
No
Yes
High blood pressure, Asthma, Diabetes, or a Heart condition?*
No
Yes
Any other health conditions not listed?*
No
Yes
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!