CRUﬁt LIABILITY WAIVER I, (PRINT NAME)_____________________________________________ , am aware that CRUfit training programs including indoor cycling, indoor rowing, suspension training, circuit training, pilates, personal training and other activities (the “Activities”) can involve strenuous physical exertion using various muscle groups, which may place stress on my joints, heart and cardiovascular system. Assumption of Risks: I acknowledge that I have voluntarily applied to participate in the Activities indicated above at CRUfit. I am awarethat these Activities may cause injury including but not limited to: 1. minor injuries such as bruises and sprains, 2. serious health problems such as abnormal blood pressure, fainting, irregular, fast or slow heart rhythm, 3. major injuries such as loss of sight, heart attack, stroke and concussions, and/or 4. catastrophic injuries including paralysis and death. I hereby accept any and all such risks of injury, health problems or death and consent to participate in the Activities indicated above. Waiver and Release: In consideration for being permitted by CRUfit to participate in the Activities and use the CRUfit facilities (the "Facilities"), I hereby agree that I, my assignees, heirs, distributes, guardians, and legal representatives will not make a claim against, sue, or attach the property of CRUfit, any of its affiliated organizations, owners, directors, employees, contractors, agents or representatives (the “The CRUfit Parties”) for any injury, damage or death resulting from my participation in the Activities or use of the Facilities or from the negligence or other acts or omissions, howsoever caused, of any of the CRUfit Parties. I hereby release the CRUfit Parties from all actions, claims or demands that I, my assignees, heirs, distributes, guardians, and legal representatives now have or may hereafter have for injury or damage resulting from my participation in the Activities or use of the Facilities. Indemnification: In addition, I will indemnify and hold harmless the CRUfit Parties from all liability for any loss, damage, or injury to persons or property arising from or relating to my use of the Facilities or participation in the Activities, including without limitation attorney’s fees, expenses and all consequential damages, whether or not resulting from the negligence of any of the CRUfit Parties. Severability: If any term of this Agreement is held to be invalid or unenforceable, the remainder shall remain valid and enforceable to the fullest extent permitted by law. All disputes arising out of this Agreement shall be subject to the exclusive jurisdiction and venue of the California state courts of Alameda County and I consent to the personal and exclusive jurisdiction and venue of these courts.
MEDICAL QUESTIONNAIRE: please answer the following IMPORTANT HEALTH QUESTIONS to the best of your ability. IMPORTANT NOTE: If you answer “YES” to any of the following questions you must provide a medical clearance from your physician prior to beginning training with us. M1: Has your doctor ever said that you have heart trouble? ............................ YES NO M2: Do you frequently have pains in your heart and chest? ............................. YES NO M3: Do you often feel faint or have spells of severe dizziness? ........................ YES NO M4: Has your doctor ever said that your blood pressure was too high?........ YES NO M5: Has your doctor ever told you that you have bone or joint problems such as arthritis, that might be made worse with exercise? ....................... YES NO M6: Is there a good physical reason not mentioned here why you should not participate in a physical training program even if you wanted to? YES NO M7: Are you over age 65 and not accustomed to vigorous exercise? .............. YES NO Acknowledgement and Understanding: I have carefully read this agreement and I am aware this is a release of liability and I am giving up substantial rights, including my right to sue. I am signing this agreement, of my own free will and intend for my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law. IF PARTICIPANT IS UNDER THE AGE OF 18 Participant Name (print) __________________________________________
Guardian Name (print) ________________________________________
Participant Signature _____________________________________________ Guardian Signature ___________________________________________ Date __________________________________________________________
FRONT DESK: check box when waiver entered into client profile