2509 W. Ave. M, Temple, Tx, 76504
RELEASE FROM LIABILITY AND ASSUMPTION OF RISK (ADULT)
PLEASE READ EACH PARAGRAPH CAREFULLY BEFORE SIGNING.
I, have applied to Junction Fitness exercise training program at the Junction Fitness facility located at 2509 W. Ave. M, Temple, Tx, 76504.
I hereby acknowledge that I should consult with my physician before beginning any exercise program.
I certify that I am not aware of any medical condition which would render me unfit to participate in any exercise program and that I will inform Junction Fitness immediately of any change in my medical condition.
I agree that if I experience symptoms such as shortness of breath, chest pain, unusual fatigue, dizziness or fainting, or extreme pain, whether or not I am under the direct supervision of my trainer, I will immediately stop exercising and inform a representative of Junction Fitness of my symptoms.
I authorize any representative of Junction Fitness to obtain emergency medical treatment for me, including transportation to a hospital or other medical facility.
I understand that if I bring my children or other children with me to Junction Fitness, I am responsible for their safety and wellbeing. I will not hold Junction Fitness or any of their representatives responsible if any child or children that are under my care and/or supervision in the gym or on the property, become injured at any time.
I UNDERSTAND AND ACKNOWLEDGE THAT THERE ARE RISKS INHERENT IN ANY EXERCISE PROGRAM
INCLUDING BUT NOT LIMITED TO HEART ATTACK, STROKE, ORTHOPEDIC INJURY, RHABDOMYOLYSIS, INJURIES CAUSED BY THE USE OF EXERCISE EQUIPMENT AND OTHERS. THESE INJURIES CAN OCCUR SUDDENLY AND WITHOUT WARNING, AND MAY RESULT IN DEATH. I AM VOLUNTARILY PARTICIPATING IN THIS TRAINING PROGRAM WITH KNOWLEDGE OF THE DANGERS INVOLVED, AND I HEREBY AGREE TO ACCEPT ANY AND ALL RISKS OF INJURY OR DEATH, AND VERIFY THIS STATEMENT BY PLACING MY INITIALS.
FOR AND IN CONSIDERATION OF PERMITTING ME TO PARTICIPATE IN THE PROGRAM, I, FOR MYSELF AND FOR MY HEIRS, BENEFICIARIES, AND PERSONAL REPRESENTATIVES, HEREBY RELEASE AND FOREVER DISCHARGE CROSSFIT DSP AND ITS DIRECTORS, OFFICERS, MEMBERS, MANAGERS, EMPLOYEES, AGENTS, ATTORNEYS, INSURERS, SUCCESSORS, AND ASSIGNS (COLLECTIVELY, “Junction Fitness parties”), FOR ANY AND ALL CLAIMS, DEMANDS, DAMAGES, LOSSES, LIABILITIES, RIGHTS, ACTIONS, CAUSES OF ACTION, EXPENSES, AND SUITS OF ANY KIND WHATSOEVER, FORESEEN OR UNFORESEEN, FOR PERSONAL INJURY, WRONGFUL DEATH, DAMAGE TO PROPERTY, OR OTHERWISE RESULTING FROM MY PARTICIPATION IN THE PROGRAM AND/OR THE ACTS OF OMISSIONS OF ANY OF JUNCTION FITNESS PARTIES, INCLUDING ANY AND ALL NEGLIGENT ACTS, WHETHER ACTIVE OR PASSIVE, IRRESPECTIVE OR WHETHER SUCH INJURIES, DEATH, OR DAMAGES OCCURE DURING TRAINING OR THEREAFTER.
I HAVE CAREFULLY READ THIS RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AT LEAST 18
YEARS OF AGE. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN ME AND
JUNCTION FITNESS AND I SIGN IT OF MY OWN FREE WILL.
Junction Fitness recommends that you clear your participation in any exercise program with you General Practitioner
HEALTH HISTORY INFORMATION:
I verify that all information notes above are accurate. I understand that it is my responsibility to update the staff of Junction Fitness of any changes in my medical status and it is also my responsibility to obtain medical clearance from my physician if needed to participate in my personal training program.