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CROSSFIT LETHAL RELEASE OF LIABILITY WAIVER

 

Waiver and Release of Liability

Express assumption of risk: I, the undersigned, am aware that there are significant risks involved in all aspects of physical training. These risks include, but are not limited to: falls which can result in serious injury or death; injury or death due to negligence on the part of myself, my training partner, or other people around me; injury or death due to improper use or failure of equipment; strains and sprains. I am aware that any of these above mentioned risks may result in serious injury or death to myself and or my partner(s). I willingly assume full responsibility for the risks that I am exposing myself to and accept full responsibility for any injury or death that may result from participation in any activity or class while at, or under direction of Crossfit Lethal. I acknowledge that I have no physical impairments, injuries, or illnesses that will endanger me or others.

I Agree

Release

In consideration of the above mentioned risks and hazards and in consideration of the fact that I am willingly and voluntarily participating in the activities offered by Crossfit Lethal, I, the undersigned hereby release Crossfit Lethal, their principals, agents, employees, and volunteers from any and all liability, claims, demands, actions or rights of action, which are related to, arise out of, or are in any way connected with my participation in this activity, including those allegedly attributed to the negligent acts or omissions of the above mentioned parties. This agreement shall be binding upon me, my successors, representatives, heirs, executors, assigns, or transferees. If any portion of this agreement is held invalid, I agree that the remainder of the agreement shall remain in full legal force and effect. If I am signing on behalf of a minor child, I also give full permission for any person connected with Crossfit Lethal to administer first aid deemed necessary, and in case of serious illness or injury, I give permission to call for medical and or surgical care for the child and to transport the child to a medical facility deemed necessary for the well being of the child.

I Agree

Indemnification

The participant recognizes that there is risk involved in the types of activities offered by Crossfit Lethal. Therefore the participant accepts financial responsibility for any injury that the participant may cause either to him/herself or to any other participant due to his/her negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to reimburse them for such fees and costs. I further agree to indemnify and hold harmless Crossfit Lethal, their principals, agents, employees, and volunteers from liability for the injury or death of any person(s) and damage to property that may result from my negligent or intentional act or omission while participating in activities offered by Crossfit Lethal, at the main building or abroad. This includes but is not limited to parks, recreational areas, playgrounds, areas adjacent to main building, and/or any area selected for training by Crossfit Lethal.

I Agree

Photography/Video Release

Participants involved in any activities offered by Crossfit Lethal may be photographed or videotaped during training. The undersigned hereby consents to the use of these photographs and/or videos without compensation, on the Crossfit Lethal website or in any editorial, promotional or advertising material produced and/or published by Crossfit Lethal.

I Agree

NO INSURANCE I acknowledge that Crossfit Lethal does not carry insurance on my behalf.



LEGAL RIGHTS I understand and acknowledge that I am surrendering valuable legal rights in this agreement.



SEVERABILITY I understand and expressly agree that this agreement is intended to be as broad and inclusive as permitted by the State of Texas and that if any portion of this agreement is held invalid, it is agreed that the balance of the agreement shall continue in full force and effect and that whatever portion is held invalid shall be interpreted and construed to afford as much protection to Crossfit Lethal as permitted by applicable law.


I have read and understood the foregoing assumption of risk, and release of liability and I understand that by signing it obligates me to indemnify the parties named for any liability for injury or death of any person and damage to property caused by my negligent or intentional act or omission. I understand that by signing this form I am waiving valuable legal rights.

 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
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

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent or Guardian's Driver's License / ID Card

Driver's License / ID Card Number*

Issuing State*
Health and Safety Issues
Do you smoke?*
No
Yes
Do you drink alcohol?*
No
Yes
How often do you exercise now?*
Are you tired or lack energy during the day?*
No
Yes
Is your sleep consistent (same time and same amount) and restful?*
No
Yes
Do you drink at least 8 glasses of water a day?*
No
Yes
Do you drink coffee or soda?*
No
Yes

Do you take prescription meds? What conditions are they prescribed for?

Do you take OTC meds? List.

Do you take herbal or nutritional supplements? List.
Do you take a multi-vitamin/mineral supplement?*
No
Yes

What do you eat in a typical week day? (M-F)?

What do you eat in a typical weekend day (Sat/Sun)?

What is your occupation?
How stressful is your job? *
Not at all
Somewhat
Very

Do you participate in any sports? Are they recreational or competitive? List.
Do you have back pain, knee pain, or shoulder pain?*
No
Yes
Sometimes
Do you have high blood pressure?*
No
Yes
Do you have high cholesterol?*
No
Yes
Are you epileptic or prone to seizures?*
No
Yes
Do you have a cardiac condition?*
No
Yes
Do you have asthma?*
No
Yes
Do you have diabetes?*
No
Yes
Do you have stiff, swollen, or painful joints?*
No
Yes
Have you lost consciousness or fell over as a result of dizziness?*
No
Yes
Do you suffer from depression?*
No
Yes
Sometimes
Have you had any broken bones or joint injuries?*
No
Yes
Have you had any surgeries?*
No
Yes
Have you ever been told by a physician to avoid any type of exercise?*
No
Yes

List any other health concerns or conditions that you have or have questions about.

What do you want to accomplish by training here? Lose weight? Improve performance? Increase strength? Get healthy? Look great at the beach?
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
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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