Informed Consent and Release of Liability
Please read the following and sign the bottom of the form. By signing this waiver, you are agreeing to the terms and conditions listed herein.
If you would like a copy, please contact us at firstname.lastname@example.org
With respect to my participation in physical activity, I understand that there may be health risks associated with activities requiring physical exertion, including but not limited to: transient dizziness, fainting, nausea, muscle cramping, musculoskeletal injury, sprains, heart attacks, stroke, or death.
I certify that I am capable of performing physical exercise and acknowledge that I am voluntarily participating in an exercise program and using equipment with knowledge of the dangers involved. I understand that I will be fully responsible for complying with any restrictions prescribed for me by my personal physician. I will review any personal wellness program with my physician prior to my commencing exercise and will periodically review my status and program with my physician. I understand that the trainers at BlackBox Strength & Conditioning are not medical professionals, and they have received training in physical activity programming for healthy individuals who do not require exercise in a medically supervised environment.
If I experience dizziness, fainting, nausea, muscle cramping, or any other symptoms while exercising, I will discontinue the activity and consult my physician.
In consideration for being allowed to participate in physical activity, I hereby agree to assume all risk of such exercise, and further agree to hold harmless the trainers of the BlackBox Strength & Conditioning facility from any and all claims, suits, losses, or related causes of action for damages, including but not limited to such claims that may result from any injury or death, accidental or otherwise, during, or arising in any way from training.
I further hereby fully release the trainers of BlackBox Strength & Conditioning and all related subsidiaries, affiliates, directors, employees, agents, successors, and assigns from any and all liability, including but not limited to: all claims, demands, actions, right of action, cause of action of whatever kind of nature, either in law or equity, arising from, relating to, or by reason of my participation in the training program, and hereby assume any and all risk and liability arising out of my participation in the training program.
This Informed Consent and Release of Liability shall be binding upon my heirs, spouse, and other next of kin, executor, administers, and assigns.