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Release of Liability Waiver (rev 7.17.20)

 

Luna Fitness Studio

Waiver and Release of Liability

 

Express assumption of risk: I, the undersigned Participant, on this day of April 19, 2024, am aware that there are significant risks involved in any physical training regimen. 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; or injury or death due to improper use or failure of equipment. Injury may result simply from the physical training itself. By its very nature, physical training seeks to have me push beyond my limits in order to produce a physical adaptation to my body. This requires feedback from me to my trainer regarding what is happening with my body. Excessive work can result in exertional rhabdomyolosis. I should look for signs of excessive soreness, darkened urine, and pain in the kidney areas in the days following a particularly intense workout. While this type of injury is relatively rare, it can occur due to a number of factors, including (but not limited to) genetic predisposition or dehydration, which are beyond the control of my trainer. 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 training with CrossFit Luna, at any of their locations, on or off premises.

 

I, the undersigned Participant, acknowledge that I have no physical impairments or illnesses that I know of that will endanger myself or others.

 

I Agree

 

Release: In consideration for being allowed to participate in the exercises and activities at CrossFit and CrossFit Luna. I, the undersigned Participant, hereby release CrossFit and CrossFit Luna, 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 Luna 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.

 

Pre-existing Condition: Participant understands and acknowledges that pre-existing physical conditions could be affected or aggravated by Participants participation in the exercises and activities conducted at CrossFit Luna ("CFL"). By participating in such exercise and activities Participant acknowledges that Participant may be endangered. Participant hereby represents to CFL that a medical doctor has cleared Participant for all physical activity and has approved my participation in the exercises and activities conducted at CFL. Participant acknowledges and agrees that CFL and its coaches, employees or agents shall not be held liable for any injuries that may occur as a result of my participation and I hereby release CFL and its coaches, employees, and agents from any such injuries. I am fully aware of, and understand the risks involved, with participation in the exercises and activities conducted at CFL and hereby assume the risk associated therewith.

 

Indemnification: The Participant recognizes that there is risk involved in the types of activities offered by CrossFit and CrossFit Luna. Therefore the Participant accepts financial responsibility for any injury that the Participant may cause either to him/herself or to any other participant or third party due to his/her negligence. Should the above mentioned parties, or anyone acting on their behalf, be required to incur attorneys fees and costs to enforce this agreement, Participant agree to reimburse them for such fees and costs. Participant further agree to indemnify and hold harmless CrossFit and CrossFit Luna, 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 acts or omissions while participating in activities offered by CrossFit and/or CrossFit Luna.

 

Photo/Video Release: Participant hereby grants CrossFit Luna permission to use my photograph/video image in any and all publications for CrossFit or CrossFit Luna, including web site entries, without payment or any other consideration in perpetuity. Participant hereby authorizes CrossFit Luna to edit, alter, copy, exhibit, publish or distribute all photos and images. I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my photo appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph or video images. Participant hereby holds harmless and releases and forever discharges CrossFit Luna from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf of on behalf of my estate which may have or may have by reason of this authorization.

 

Kids Room Policies (Ages 3+): You acknowledge that the kids room is NOT supervised. Parent/caregiver MUST remain ON-SITE while child(ren) is/are in the kids room. You may bring any items that your child may require during the session such as special toys, or other comfort items. We DO allow iPods/iPads/Game Boys/etc., but the child may be asked to turn the sound down or all the way off, if needed. Please put your children's shoes in the shoe cubbies by the front door and have your child use the restroom before joining the Kids room. No food or drinks will be permitted, with the exception of water (please label with child's name). This is due to possible spills and potential allergies of other children. To keep everyone healthy and safe, we ask that you do NOT bring your child if they are sick ,have had a fever (and not on a fever reducing medication) within the last 24 hours, or have had any recent exposure to a contagious illness. If your child displays repeated behavioral concerns (biting, hitting, hair pulling, etc), you will be asked to leave your child at home. We know that situations arise and we will always let parents know if there are any concerns/incidents. We want your Kid's experience to be worry free and will do our best to provide fun things to do.

By signing below I acknowledge that I have read, understand, and agree to the above kids room policies. I understand that by signing this waiver, I release and hold harmless CrossFit Luna, and its owners, directors, employees, and all other persons or entities acting for them from any liability as a result of personal injury or property damage occurring while the above child is inside of CrossFit Luna. I understand that Kids room is provided ONLY WHILE I AM PRESENT at the studio and taking class, workshop, etc. I understand that if my child should become inconsolable during the class session, I am required to leave the class and attend to my child.

I am competent to contract in my own name. I have read this Waiver and Release of Liability, and I fully understand the contents, meaning, and impact of this release.

 

COVID-19  Please understand that despite all the precautions that you, other members, and/or CrossFit Luna may take, we cannot guarantee your health or safety, and you may still be exposed to COVID-19, including through interactions with other individuals who have COVID-19. By executing this release and gaining access to the facility, you, on behalf of yourself, your heirs, beneficiaries, representatives, successors and assigns: (1) voluntarily assume all risks associated with any exposure to COVID-19, including, but not limited to suffering any type of medical condition, illness and, potentially, death; and (2) knowingly and voluntarily waive, release, covenant not to sue, forever discharge, indemnify, and hold harmless COMPANY, its parents and subsidiaries and their respective officers, directors, employees, contractors, agents, representatives, successors and assigns (“Released Parties”) from any and all liability, damages, losses, suits, demands, causes of action to the fullest extent permitted by the laws of this state, or any other claims of any nature whatsoever, arising out of or relating in any way to your use of the facility and your potential exposure to COVID-19.

 

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.

I Agree

First Athlete's Name

First Name*

Last Name*

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

First Name*

Last Name*

Phone*
Second Athlete's Date of Birth*
Third Athlete's Name

First Name*

Last Name*

Phone*
Third Athlete's Date of Birth*
Fourth Athlete's Name

First Name*

Last Name*

Phone*
Fourth Athlete's Date of Birth*
Fifth Athlete's Name

First Name*

Last Name*

Phone*
Fifth Athlete's Date of Birth*
Sixth Athlete's Name

First Name*

Last Name*

Phone*
Sixth Athlete's Date of Birth*
Seventh Athlete's Name

First Name*

Last Name*

Phone*
Seventh Athlete's Date of Birth*
Eighth Athlete's Name

First Name*

Last Name*

Phone*
Eighth Athlete's Date of Birth*
Ninth Athlete's Name

First Name*

Last Name*

Phone*
Ninth Athlete's Date of Birth*
Tenth Athlete's Name

First Name*

Last Name*

Phone*
Tenth Athlete's Date of Birth*
Athlete'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*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Additional Information
Are you interested in a CrossFit Luna Membership? *
Yes
No

How did you hear about CrossFit Luna?
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 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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