Preview mode
Published
Copy responder link
Request edit access
Waiver of Liability
I ask that all those who participate accept the terms of this Liability Waiver prior to joining this event and beginning any exercise. Something such as this would normally be filled out if you are were to come to an in-person class, therefore, I will ask that you read the terms completely before accepting admittance into this event.

INFORMED CONSENT FOR EXERCISE PARTICIPATION
I desire to engage voluntarily in an exercise program given by Lil Bit (Jerrose) and other instructors. I understand that the activities may be strenuous, and may require me to do body movement that I am not familiar with in order to improve overall fitness. I understand that I am responsible for monitoring my own condition throughout my workouts. Should any unusual symptoms occur, I will cease my participation.

In virtually signing this consent form, I affirm that I have read, accept and understand this form in its entirety and that I understand the nature of the exercise. I know that there may be risks associated with fitness classes and willingly accept those possibilities. I know that it is my responsibility to ensure my own safety. I take full responsibility for my own health and safety in participating in the fitness class and to the extent I deem advisable, will consult a physician before participating in any of the activities.

Therefore, intending to be bound and as a condition of being allowed to participate in the fitness event; I have virtually signed this waiver.
Untitled Title
Clear selection
First Name *
Last Name *
AGREEMENT AND WAIVER / RELEASE OF LIABILITY
In consideration for being allowed to participate in this activity, which I do freely and voluntarily for my own personal benefit, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors and assigns to:
1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist. I acknowledge this risk. *
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation. *
3. I willingly agree to comply with the stated and customary terms and conditions for participation.  If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the Company immediately. *
4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY  RELEASE, INDEMNIFY, AND HOLD HARMLESS THE  instructor, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used for the activity ("Releases"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. *
5. I give Lil Bit (Jerrose) and all instructors included permission to use my picture(s) / video(s) in or on any form of advertisement for Lil Bit (Jerrose) and all instructors included  or affiliated event. *
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT , FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. *
MM
/
DD
/
YYYY
Please Sign Full Name Below Electronically *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms