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WAIVER AND RELEASE

I hereby enter into the following agreement with Barbell Medicine LLC (a Missouri entity with principal place of business in Missouri), as well as its members, officers, employees, agents, and representatives (individually and collectively, “BARBELL MEDICINE”), as a condition of receiving and using BARBELL MEDICINE’s fitness and performance consultation and services.

  1. I acknowledge and fully understand that BARBELL MEDICINE will endeavor to provide the most effective principles to help achieve my fitness, performance, and personal goals, but cannot guarantee that any services, products, programs, methods, workouts, recommendations, or routines will be safe, effective or suitable for everyone. All such products and services, programs, techniques, recommendations, and materials embodied in such products and services are offered without warranties or guarantees of any kind, expressed or implied, including, but not limited to, warranties of safety or fitness for any particular purpose.  Further, I hereby waive, release, and discharge BARBELL MEDICINE from any and all liability from death, injuries or damages arising from, or in any way connected with, use of its services, products, programs, methods, workouts, recommendations, or routines, including any death, injuries or damages resulting from the negligent recommendations, acts, or omissions of BARBELL MEDICINE.
  2. I acknowledge and fully understand that any fitness or exercise activities, and the use of training and fitness equipment and machinery, involve risks of serious injury, permanent disability, or death, even if done correctly and with utmost attention to safety. These risks include, but are not limited to, fainting; broken bones; strained or torn muscles; torn or strained ligaments, tendons, and other connective tissues; herniated discs and other spinal injuries; cardiovascular or cerebrovascular events, including heart attack or stroke; conditions related to overexertion, including heat stroke/exhaustion or rhabdomyolysis; or damage to the nervous system, including irreversible damage to the brain or spinal cord. I further acknowledge and fully understand that participation in any fitness or exercise activities could aggravate a pre-existing condition, whether known or unknown, and that there may be other risks associated with my participation in fitness or exercise activities that are not known or not reasonably foreseeable at this time. I hereby acknowledge and accept the risks of the foregoing dangers. Further, I hereby waive, release, and discharge BARBELL MEDICINE from any and all liability from death, injuries or damages arising from, or in any way connected with, BARBELL MEDICINE’s fitness and performance consultation and services; BARBELL MEDICINE’s instruction, coaching, or recommendations; the use of any exercises, routines, equipment or machinery recommended by BARBELL MEDICINE; or my engagement in any fitness or exercise activities, including any death, injuries or damages resulting from the negligent recommendations, acts, or omissions of BARBELL MEDICINE.
  3. I acknowledge and understand that BARBELL MEDICINE’s members, employees, agents, and representatives are not licensed dietitians.  I acknowledge, understand, and agree that although BARBELL MEDICINE’s members, employees, agents, or representatives may be licensed physicians, BARBELL MEDICINE’s fitness and performance consultation and services are not intended to and do not constitute or create a physician/patient relationship.  I acknowledge and agree that any information, guidelines, or advice provided by BARBELL MEDICINE are not intended to constitute and shall not be construed as dietetic or medical advice or as treatment for any general or particular medical condition or pathology, and that they carry no express or implied warranty of any kind, including, but not limited to, warranties regarding safety or suitability for a particular purpose.
  4. I understand that a physician’s approval is highly recommended prior to participating in any type of fitness or exercise activity, and I hereby represent that I have either obtained a signed approval from my physician, or that I acknowledge the risks inherent in such activities but have elected to engage in said activities without seeking prior approval by a physician.
  5. If a court of competent jurisdiction, or any other legal authority or governmental agency, declares any provision of this agreement invalid, such invalidation shall not affect the remaining provisions of this agreement, which shall remain in full force and effect.  If any sentence, clause, phrase, or term of any section of this agreement is deemed invalid, the remainder of that section shall remain in full force and effect.
  6. Any suit brought under this agreement, or in relation to any consultation or services provided under this agreement, shall be brought in the Eleventh Judicial Circuit Court of the State of Missouri, and both parties irrevocably consent to venue and jurisdiction in that court.  This agreement shall be governed by Missouri law, irrespective of any choice of law principles.  The parties’ legal rights and obligations relating to this agreement and relating to the consultation and services provided under this agreement shall be governed by Missouri law, irrespective of any choice of law principles.  This agreement shall be deemed to have been agreed to and executed in Missouri.
  7. I HAVE READ THIS AGREEMENT IN ITS ENTIRETY AND AGREE TO ADHERE TO ALL ITS PRECEPTS. Any questions that I may have had relating to anything in this agreement have been answered to my satisfaction. This document encompasses the entire agreement of the parties and supersedes all prior oral and written representations between the parties, if any.  This agreement may be amended only by a written agreement, signed by both parties.

Today's Date: May 7, 2024

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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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*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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