As further consideration for the School accepting the Student(s) and providing the instruction designated above, I represent that the Student(s) designated above is (are) a)fully capable of participating in fitness kickboxing and group strength training classes, b) that the health of the student(s) designated above have been evaluated by a qualified physician and c) that the student(s) has(have) not been prohibited from any type of exercise or physical activity.
ASSUMPTION OF RESPONSIBILITY AND RISK
I understand that physical exercise is potentially dangerous. The possibility of injury or aggravation of prior injuries is possible. I understand that all participants have the right and responsibility to excuse themselves from any exercise or activity they believe will be harmful to them. All participants must evaluate each situation in the context of their skill and current physical condition, and conduct each exercise in a manner that is safe. If an instructor gives an instruction that is unsafe for the participant, it is the participant’s responsibility to inform the instructor that the skill may be unsafe.
I understand the above statement of risk, and I understand the rights and responsibilities of participants. I assume responsibility of my own safety (or safety of my child), understanding and accepting the risks involved with group fitness activities and physical fitness testing. By assuming this risk, I completely absolve all instructors, staff, guests, participants, landlords, management companies and any and all other parties of liability for my harm, unless intentionally caused.
I agree to indemnify the school for any liability for injury from the hazards of group fitness and all related activies.
I hereby give informed consent to engage in a series of procedures relative to providing relevant information about my health history, taking a series of exercise tests, and participating in a variety of physical activities. I understand the purpose of the testing is to determine my level of physical fitness.
In the event of a medical problem, I recognize that any medical care that may be required is my personal financial responsibility.
I understand that the information collected during testing and on the health history will only be used to evaluate my fitness levels. I give informed consent for my information to be used in an anonymous manner for the purpose of providing sample program result statistics for marketing or research.
CONSENT TO USE PHOTOGRAPHS
IN THE EVENT YOU ARE A PRIZE WINNER, THE FOLLOWING APPLIES: Farrell’s eXtreme Bodyshaping, Inc. periodically conducts contest, and awards prizes to participants based upon such participant’s overall physical improvement, attitude and other factors considered relevant. As a condition to receipt of any such prize, I hereby authorize Farrell’s eXtreme Bodyshaping, Inc, or its affiliates and franchises, to take and use visual/audio images of me, including, but not limited to photographs, digital images, drawings, renderings, sound or video recordings, audio clips or accompanying written descriptions. I agree that Farrell’s eXtreme Bodyshaping, Inc. owns the images and all rights related to them. The images may be used in any manner, media or format (including promotional advertising), without limitation as to frequency or duration, and without notifying me in advance.
Should any dispute arise between me, my child, or anyone acting on behalf of my child, regarding this school, then I specifically agree that the dispute shall be resolved in binding arbitration. Should a suit be filed in Court, I specifically authorize the Court to order the case to binding arbitration.
SEVERABILITY AND DURABILITY
If any clause, sentence, phrase or statement is found unenforceable or invalid by any court of law, the remainder of the document shall remain valid enforceable and the invalid clause, sentence, phrase or statement shall be considered struck from the document. This document is effective from the date signed with no expiration. Furthermore, the terms of this document are retroactive to the beginning of training and visiting the school if this document was signed after that date.
SIGNATURE _____________________________________________ DATE _______________________