WAIVER OF LIABILITY FOR GYM USE AT PUMP FITNESS 350 LITTLE EAST NECK RD. WEST BABYLON NY , 11704 631-500-9166

I/We hereby understand and acknowledge that the training, programs and events held by PUMP Fitness may expose me to many inherent risks, including accidents, injury, illness, or even death. I/We assume all risk of injuries associated with participation including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat and/or humidity, and all other such risks being known and appreciated by me.

I/We hereby acknowledge my responsibility in communicating any physical and psychological concerns that might conflict with participation in activity.

 I/We acknowledge that I am physically fit and mentally capable of performing the physical activity I choose to participate in.

After having read this waiver and knowing these facts, and in consideration of acceptance of my participation at PUMP Fitness furnishing services to me, I agree, for myself and anyone entitled to act on my behalf, to HOLD HARMLESS, WAIVE AND RELEASE PUMP Fitness, its officers, agents, employees, organizers, representatives, and successors from any responsibility, liabilities, demands, or claims of any kind arising out of my participation in private and or group training, programs and/or events.

By my signature I/We indicate that I/We have read and understand this Waiver of Liability. I am aware that this is a waiver and a release of liability and I voluntarily agree to its terms.

Participant’s Name (Please Print): ____________________________________________________

Participant’s Signature: __________________________________________ Date: _____________________

In case of emergency, contact: _____________________________________ Phone: ____________________

I represent that I have legal capacity and authorize to act on behalf of the minor named herein. I take full responsibilty for my child any injury or sickness while in facility , PUMP Fitness is NOT responsible for injury in or outside of premise .

Parent/Guardian Signature: _____________________________ Date: __________